Individual provider Active NPI

Maxwell C Shaw-Jones, APRN

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1295414746
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61468286 Issued in WA
Practice address
8720 14TH Ave S
Seattle, WA 98108-4807
Phone
(206) 762-3730
NPI assigned
Jul 12, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 61448412 WA
Primary Care Nurse Practitioner 363LP2300X AP61468286 WA
Family Nurse Practitioner 363LF0000X AP61468286 WA Primary

Addresses

Primary practice location

8720 14TH Ave S
Seattle, WA 98108-4807

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (253) 681-6603

Other identifiers 1

IdentifierTypeStateIssuer
2263480MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20231107002144 WA Practitioner - Nurse Practitioner 1951758382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

8720 14TH Ave S
Seattle, WA 98108-4807
Phone (206) 762-3730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
61448412WAMDCommunity Health Registered Nurse
AP61468286WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Sep 25, 2023 Accepting new patients
Sea Mar Community Health Centers CurrentSince Sep 25, 2023 Accepting new patients
Sea Mar Community Health Centers Family Current Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Organizations & group practices 4

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1295414746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "253-681-6603",
            "fax_number": "206-764-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 14TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084807",
            "telephone_number": "206-762-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW-JONES",
        "first_name": "MAXWELL",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "WA",
            "license": "61448412",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61468286",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61468286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2263480",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.