Angela L Shaw, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP05787 Issued in LA

Practice address

17609 Old Jefferson Hwy Ste a
Prairieville, LA 70769-3980

Phone

(225) 647-8511

Fax

(225) 743-2085

NPI assigned

Mar 23, 2009

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aellzey14664@direct.casso.us.com

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.

• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1164422630
  Medicare reassignment NPD
• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Nurse Practitioner

  Medicare reassignment NPD
• The ADHD Cornerstone Clinic, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Prairieville, LA
  • NPI 1912559568
  NPD Authorized official
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1972818250
  NPD
• Health Care Centers in Schools

  • Clinic/Center
  • Baton Rouge, LA
  • NPI 1467678045
  NPD (past)
• Our Lady of the Lake Hospital Inc

  • Pediatric Gastroenterology Physician
  • Baton Rouge, LA
  • NPI 1952355125
  NPD (past)
• Professional Emergency Physician Associates, LLC

  • Emergency Medicine Physician
  • Baton Rouge, LA
  • NPI 1992758247
  NPD (past)

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1154562049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-343-9505",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17609 OLD JEFFERSON HWY STE A",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693980",
            "telephone_number": "225-647-8511",
            "fax_number": "225-743-2085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1937 S Burnside Ave",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707374632",
            "country_code": "US",
            "telephone_number": "225-765-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6650 Glen Oaks Drive",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "70812",
            "country_code": "US",
            "telephone_number": "225-355-9759",
            "fax_number": "225-355-8650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12525 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708101907",
            "country_code": "US",
            "telephone_number": "225-765-8341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5959 S Sherwood Forest Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708166038",
            "country_code": "US",
            "telephone_number": "225-343-9505",
            "fax_number": "225-343-9171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "RN107541",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP05787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1884910",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aellzey14664@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "aellzey14664@direct.casso.us.com",
            "address_1": "1937 S Burnside Ave",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707374632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1937 S Burnside Ave",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707374632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Krista L Scurria, P.T.
• Self Cath Solutions
• Semeko Cox, LLC
• Kishan Shah, PT
• Candace Sharper, LPC
• Desiree Shaw, MS, PLPC
• Shelly Chiropractic LLC
• Matthew Joseph Shelly, D.C.
• Simone Elloie Shelton, ED. D
• Samantha Simone Sheppard

• Pediatric Nurse Practitioner in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.