NPIMap

Individual provider Active NPI

Renita Ta'Sha Shaw, DPM

  • Foot Surgery Podiatrist
  • Wiggins, MS
National Provider Identifier
1376783324
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
80199 Issued in MS
Practice address
1434 Central Ave E
Wiggins, MS 39577-9602
Phone
(601) 928-6700
Fax
(601) 928-6731
NPI assigned
Mar 4, 2009
Last updated
Jun 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 80199 MS Primary

Addresses

Primary practice location

1434 Central Ave E
Wiggins, MS 39577-9602

Mailing address

1434 E Central Ave.
Stone County Hospital
Wiggins, MS 39503
Phone (601) 928-6700

Other names 1

  • Dr. Renita Ta'Sha Parker Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100407000032 MS Practitioner - Podiatry 3577699180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

1440 Central Ave E
Wiggins, MS 39577-9602
Phone (601) 928-6700

147 Reynoir St
Biloxi, MS 39530-4121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80199MSMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Feb 26, 2020 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Feb 26, 2020 Accepting new patients
Stone County Hospital, Inc Past Accepting new patients
Premier Foot Clinic PC Foot Surgery PastSince Sep 4, 2005 Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

1434 Central Ave E
Wiggins, MS 39577
Phone (601) 928-6600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9847/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GHJHBD
  • Direct secure messaging: rshawparker@direct.mhg.com

Organizations & group practices 6

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.

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1376783324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 E CENTRAL AVE.",
            "address_2": "STONE COUNTY HOSPITAL",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "39503",
            "telephone_number": "601-928-6700",
            "fax_number": "601-928-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 CENTRAL AVE E",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395779602",
            "telephone_number": "601-928-6700",
            "fax_number": "601-928-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "RENITA",
        "middle_name": "TA'SHA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MS",
            "license": "80199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENITA",
            "last_name": "PARKER",
            "middle_name": "TA'SHA",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wiggins, MS

Sources for this page

Verify at the official NPI Registry.