Kimberlee Shaw, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

141280 Issued in NC

Practice address

301 E Wendover Ave
Suite 215, Wendover Medical Center
Greensboro, NC 27401-1230

Phone

(336) 379-1156

Fax

(336) 370-0442

NPI assigned

Jun 26, 2007

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of North Carolina at Chapel Hill School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care, Inc Home health agency, Greensboro, NC, CCN 347211
• Authoracare Collective Hospice, Greensboro, NC, CCN 341503
• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1457436982
  Medicare reassignment Care Compare group NPD
• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1407929094
  NPD
• Eagle Physicians and Associates PA

  • Physical Therapist
  • Greensboro, NC
  • NPI 1790491751
  NPD
• Eagle Physicians and Associates PA

  • Primary Care Clinic/Center
  • Greensboro, NC
  • NPI 1184665499
  NPD (past)
• Eagle Physicians and Associates PA

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1396852570
  NPD (past)
• Eagle Physicians and Associates PA

  • Sleep Medicine (Internal Medicine) Physician
  • Greensboro, NC
  • NPI 1609070648
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Authoracare Collective

  • Community Based Hospice Care Agency
  • Greensboro, NC
  • NPI 1093774614
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Greensboro, NC
  • NPI 1619236924
  Care Compare affiliation
• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1245436203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14883",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274154883",
            "telephone_number": "336-274-6515",
            "fax_number": "336-275-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E WENDOVER AVE",
            "address_2": "SUITE 215, WENDOVER MEDICAL CENTER",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011230",
            "telephone_number": "336-379-1156",
            "fax_number": "336-370-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KIMBERLEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "141280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915807",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9449525",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RTL",
            "identifier": "141280",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberlee.shaw@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "301 E Wendover Ave",
            "address_2": "Suite 215, Wendover Medical Center",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eva Nicolene Proescholdt Shaw, M.D.
• Inez Gooden Shaw, RN
• Jill Suzanne Shaw, MED, RD, LDN
• Jo Ann G. Shaw, M.D.
• William Douglas Shaw, Jr., MD
• Kimberly Dawn Shaw, CNM
• Robert Boyd Shaw Jr., L.P.C.
• Senetria Renea Shay, NCC, LPC
• Muhammad Ali Shazib, DMD
• Shear Passion Hair Studio LLC

• Family Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.