Kristy Michele Shaw, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT0003399 Issued in GA

Practice address

304 Emory St
Valdosta, GA 31602-1808

Phone

(229) 244-1667

Fax

(229) 244-8253

NPI assigned

Apr 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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.

• Azalea Rehab Services, LLC

  • Speech-Language Pathologist
  • Valdosta, GA
  • NPI 1992062426

  Occupational Therapist

  Medicare reassignment NPD
• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469
  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1215990510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 EMORY ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021808",
            "telephone_number": "229-244-1667",
            "fax_number": "229-244-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 EMORY ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021808",
            "telephone_number": "229-244-1667",
            "fax_number": "229-244-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KRISTY",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT0003399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00919465A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hala Sharma, MD
• Shaleekha Sharma, MD
• Vibhuti Sharma, M.D.
• John Michael Sharon, M.D.
• Christa Shaw
• Joshua Peter Shea, CRNA
• Peter F Shea III, CRNA
• Kelly Marie Sheaks, MMFT
• Clinton McWilliams Sheffield, D.C.
• Jeri Lynn Sheffield, D.O.

• Occupational Therapist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.