Forrest Crane Shaw

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

407 W Loucks St
Sheridan, WY 82801-4128

Phone

(307) 763-6062

NPI assigned

Dec 8, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1053917823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W WHITNEY ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828014719",
            "telephone_number": "307-763-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W LOUCKS ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828014128",
            "telephone_number": "307-763-6062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 Main St",
            "address_purpose": "LOCATION",
            "city": "Ranchester",
            "state": "WY",
            "postal_code": "828395053",
            "country_code": "US",
            "telephone_number": "307-763-6062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "FORREST",
        "middle_name": "CRANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "secure",
            "affiliation": "Y",
            "endpointDescription": "mental health",
            "affiliationName": "King & Samson Consulting Services LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "407 W Loucks St",
            "city": "Sheridan",
            "state": "WY",
            "country_code": "US",
            "postal_code": "828014128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Joseph Shassetz, PHARM.D
• Colleen R. Shaw, M.D.
• Christine E Shepherd, CMT, NCBTMB, LPC
• Brian D Sheremeta, LMFT
• Sheridan Anesthesia Associates LLC
• Sheridan Counseling Practice, LLC
• Sheridan Eye Care Center Inc

• Case Manager/Care Coordinator in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Case Manager/Care Coordinator in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.