Active NPI
Kathleen Gem Shaw, PSYD
- Clinical Neuropsychologist
- Falls Church, VA
National Provider Identifier
1417459835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 0810008398
- Practice address
- 5805 Arnet St
Falls Church, VA 22041-1601 - Phone
- (571) 244-9875
- NPI assigned
- Mar 1, 2018
- Sex
- Female
- Sole proprietor
- No
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 Neuropsychologist | 103G00000X | 0810008398 | VA | Primary |
Addresses
Primary practice location
5805 Arnet St
Falls Church, VA 22041-1601
Mailing address
5805 Arnet St
Falls Church, VA 22041-1601
Phone (571) 244-9875
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810008398 | VA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1417459835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5805 ARNET ST",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220411601",
"telephone_number": "571-244-9875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5805 ARNET ST",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220411601",
"telephone_number": "571-244-9875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "KATHLEEN",
"middle_name": "GEM",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-01",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "VA",
"license": "0810008398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.