Individual provider Active NPI

Breanna Shaw, FNP

  • Family Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1093450421
Registry record updated Oct 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184186 Issued in VA
Practice address
800 Battlefield Blvd N
Chesapeake, VA 23320-4802
Phone
(757) 842-4481
Fax
(757) 312-3076
NPI assigned
Apr 29, 2022
Last updated
Oct 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 0024184186 VA
Family Nurse Practitioner 363LF0000X 0024184186 VA Primary

Addresses

Primary practice location

800 Battlefield Blvd N
Chesapeake, VA 23320-4802

Mailing address

667 Kingsborough SQ Ste 101
Chesapeake, VA 23320-4999
Phone (757) 842-4481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912003000 VA Practitioner - Nurse Practitioner 3173908100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians

Practice addresses (Care Compare)

2544 Bainbridge Blvd
Suite B
Chesapeake, VA 23324-1859
Phone (757) 312-6790

300 Medical Pkwy
Chesapeake, VA 23320-4985

800 Battlefield Blvd N
Chesapeake, VA 23320-4802
Phone (757) 312-3085

844 Battlefield Blvd N
Chesapeake, VA 23320-4802
Phone (757) 312-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.57 of 100Reported as group
Quality
87.01
Promoting interoperability
100
Improvement activities
40
Cost
81.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024184186VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Regional Medical Group CurrentSince Aug 1, 2024 Accepting new patients
Signify Health, LLC CurrentSince May 31, 2022 Accepting new patients
Chesapeake Regional Medical Group Family CurrentSince Aug 1, 2024 Accepting new patients
Colon Rectal Surgery of Tidewater, P.C. Past Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

112 Gainsborough Sq
Ste 100
Chesapeake, VA 23320
Phone (757) 312-8221

1301 Executive Blvd
#200
Chesapeake, VA 23320
Phone (757) 312-3132

1464 Mount Pleasant Rd
#1314
Chesapeake, VA 23322

2544 Bainbridge Blvd
Ste B
Chesapeake, VA 23324
Phone (757) 312-6790

300 Medical Pkwy
Chesapeake, VA 23320
Phone (757) 312-6102

667 Kingsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 312-3132

800 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-3085

908 Eden Way N
Ste 101
Chesapeake, VA 23320
Phone (757) 312-6267

680 Oyster Point Rd
Ste 105
Newport News, VA 23606
Phone (757) 668-4851

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

Interoperability endpoints

  • Direct secure messaging: breanna.olden.1@5072.direct.athenahealth.com
  • Direct secure messaging: breanna.olden.2@5072.direct.athenahealth.com
  • Direct secure messaging: breanna.olden.3@5072.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793145600000",
    "number": "1093450421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "757-842-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BATTLEFIELD BLVD N",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204802",
            "telephone_number": "757-842-4481",
            "fax_number": "757-312-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BREANNA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024184186",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.