Lindsey Shaw, APRN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN.CNP.0029608 Issued in OH

Practice address

5030 N Walnut St
South Bloomfield, OH 43103-1018

Phone

(740) 983-0015

Fax

(740) 983-4763

NPI assigned

Mar 27, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Community Practices, LLC

  • Pediatrics Physician
  • Mansfield, OH
  • NPI 1386031896
  Medicare reassignment NPD

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1326625054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 S WALNUT ST",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431031029",
            "telephone_number": "740-983-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 N WALNUT ST",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431031018",
            "telephone_number": "740-983-0015",
            "fax_number": "740-983-4763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Colemans Crossing Blvd",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "OH",
            "postal_code": "430407080",
            "country_code": "US",
            "telephone_number": "937-642-0535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6051 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430178218",
            "country_code": "US",
            "telephone_number": "614-799-6044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "LINDSEY",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.0029608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0467322",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "lindsey.labarge@Nationwidechildrens.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "700 Childrens Dr",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432052639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Marie McDorman
• Lana J Pollock
• Jerry Gaines Purvis Jr., M.D.
• Dawn Riegel, LPCC-S
• Madeleine Flore Sactchom
• Ultimate Healthcare LLP
• Bodi Grayson Wallace
• Katelin Marie Wallace
• Lindsay Nicole Wallace
• Sheila Ann Wallace

• Pediatric Nurse Practitioner in South Bloomfield, OH
• Providers in South Bloomfield, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.