Individual provider Active NPI

Shawna Stone

  • Clinical Social Worker
  • Watertown, NY
National Provider Identifier
1154708121
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092345 Issued in NY
Practice address
211 J.B. Wise Plaza
Watertown, NY 13601
Phone
(315) 782-7445
Fax
(315) 779-1184
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 092345 NY Primary
Social Worker 104100000X 096872-1 NY

Addresses

Primary practice location

211 J.B. Wise Plaza
Watertown, NY 13601

Mailing address

PO Box 6550
Watertown, NY 13601-6550
Phone (315) 782-7445

Other practice location 1

167 Polk St
Suite 300
Watertown, NY 13601-2770
Phone (315) 782-7445

Other names 1

  • Shawna McKeever Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
096872-1NYMDSocial Worker
092345NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Home of Jefferson County CurrentSince Sep 10, 2023 Accepting new patients

Locations

211 Jb Wise Pl
Watertown, NY 13601
Phone (315) 788-7430

167 Polk St
Ste 300
Watertown, NY 13601

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1154708121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6550",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136016550",
            "telephone_number": "315-782-7445",
            "fax_number": "315-779-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 J.B. WISE PLAZA",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-782-7445",
            "fax_number": "315-779-1184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Polk St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136012770",
            "country_code": "US",
            "telephone_number": "315-782-7445",
            "fax_number": "315-779-1184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "SHAWNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092345",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096872-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "MCKEEVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.