Alexandra Corley Shaw, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

24667 Issued in SC

Practice address

429 Roper Mountain Rd Ste 901
Greenville, SC 29615-4254

Phone

(864) 734-7165

Fax

(864) 203-4587

NPI assigned

Feb 10, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexandra.shaw.1@23809.direct.athenahealth.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.

• Mountain View Mental Health, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenville, SC
  • NPI 1306565130
  NPD Authorized official
• TMS Neurohealth South Carolina LLC

  • Psychiatry Physician
  • Greenville, SC
  • NPI 1942762315
  NPD

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1205428349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENNWOOD LN",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296091643",
            "telephone_number": "803-269-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 ROPER MOUNTAIN RD STE 901",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154254",
            "telephone_number": "864-734-7165",
            "fax_number": "864-203-4587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1911 Gadsden St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292016400",
            "country_code": "US",
            "telephone_number": "803-335-5232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALEXANDRA",
        "middle_name": "CORLEY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "24667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Wells Shatten, N.P.
• Emily Christine Shattuck
• John C Shaughnessy, PHARM.D., RPH.
• Kathleen Marie Shaughnessy, DPT
• Shaw Corporation
• Brandi Nicole Shaw, OTR/L
• Cynthia May Fagan Shaw
• Harold E Shaw Jr., M.D.
• Karen D Shaw, RN
• Kelley P Shaw

• Psychiatric/Mental Health Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.