Individual provider Active NPI

Dian Shawver, LMSW

  • Clinical Social Worker
  • Pocatello, ID
National Provider Identifier
1124269527
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW-27362 Issued in ID
Practice address
1023 Yellowstone Ave
Ste J
Pocatello, ID 83201-4478
Phone
(208) 478-9551
Fax
(208) 478-1507
NPI assigned
Mar 13, 2009
Last updated
Mar 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LMSW-27362 ID Primary

Addresses

Primary practice location

1023 Yellowstone Ave
Ste J
Pocatello, ID 83201-4478

Mailing address

1023 Yellowstone Ave
Ste J
Pocatello, ID 83201-4478
Phone (208) 478-9551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-27362IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1124269527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 YELLOWSTONE AVE",
            "address_2": "STE J",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014478",
            "telephone_number": "208-478-9551",
            "fax_number": "208-478-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 YELLOWSTONE AVE",
            "address_2": "STE J",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014478",
            "telephone_number": "208-478-9551",
            "fax_number": "208-478-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWVER",
        "first_name": "DIAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-27362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; 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.