Active NPI
Shaw Eberhardt, LCSW
- Clinical Social Worker
- Tampa, FL
National Provider Identifier
1386915866
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Aug 20, 2018.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW10368
- Practice address
- 6105 Memorial Hwy
Suite C
Tampa, FL 33615-4597 - Phone
- (813) 391-3273
- Fax
- (813) 882-0221
- NPI assigned
- Jan 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW10368 | FL | Primary |
Addresses
Primary practice location
6105 Memorial Hwy
Suite C
Tampa, FL 33615-4597
Mailing address
6105 Memorial Hwy
Suite C
Tampa, FL 33615-4597
Phone (813) 391-3273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326672000000",
"number": "1386915866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6105 MEMORIAL HWY",
"address_2": "SUITE C",
"city": "TAMPA",
"state": "FL",
"postal_code": "336154597",
"telephone_number": "813-391-3273",
"fax_number": "813-882-0221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6105 MEMORIAL HWY",
"address_2": "SUITE C",
"city": "TAMPA",
"state": "FL",
"postal_code": "336154597",
"telephone_number": "813-391-3273",
"fax_number": "813-882-0221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHARDT",
"first_name": "SHAW",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-16",
"last_updated": "2012-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW10368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.