Benjamin Allen Shaw, L.I.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007817 Issued in IA

Practice address

1690 Elm St Ste 300
Dubuque, IA 52001-3679

Phone

(563) 690-2850

Fax

(563) 557-8488

NPI assigned

Jun 23, 2015

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

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Crescent Community Health CenterGroup PAC ID 0345343158, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Crescent Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Dubuque, IA
  • NPI 1720146319
  Medicare reassignment Care Compare group NPD
• The Finley Hospital

  • Emergency Medicine Physician
  • Dubuque, IA
  • NPI 1134176308
  NPD (past)

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1124400510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-2850",
            "fax_number": "563-557-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-2850",
            "fax_number": "563-557-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BENJAMIN",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dori Sevde, APRN
• Michael Chandler Severson
• Tina Lee Shade, MT
• Michelle Shafer, D.O.
• Roger D. Shafer, M.D.
• Keith Alan Shaw, MD
• Shelby Anna Shelley
• Amy Sherman
• Jessica Sherman, OTR/L
• Karoline Sheston

• Clinical Social Worker in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.