Alicia C Shaw, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2016043696 Issued in MO

Practice address

300 N Morley St Ste a-C
Moberly, MO 65270-2334

Phone

(660) 263-1225

Fax

(660) 263-1613

NPI assigned

Dec 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

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.

• Pike County Memorial Hospital

  • Rural Health Clinic/Center
  • Bowling Green, MO
  • NPI 1124030424
  Medicare reassignment NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1689760076
  Medicare reassignment NPD
• Pike County Memorial Hospital

  • Rural Health Clinic/Center
  • Bowling Green, MO
  • NPI 1134633456
  NPD
• Pike County Memorial Hospital

  • Family Medicine Physician
  • Bowling Green, MO
  • NPI 1962933143
  NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1285404434
  NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1548993942
  NPD

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1124563275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "660-263-1225",
            "fax_number": "660-263-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MORLEY ST STE A-C",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652702334",
            "telephone_number": "660-263-1225",
            "fax_number": "660-263-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALICIA",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A153239",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016043696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sams Prescription Shop Inc
• Sams Prescription Shop Inc
• Valarie Lynn Schoen, PTA
• Seidel Christian Counseling
• Hayley Seidel, LPC
• Sheridan Emergency Physician Services of North Missouri, Inc.
• Samuel Livaudois Simpson, MD
• Skilled Nursing Services LLC
• Smile Dental Associates, LLC
• Alicia Elizabeth Smith

• Family Nurse Practitioner in Moberly, MO
• Providers in Moberly, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.