Nicole Lynn Shaw, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704299077 Issued in MI

Practice address

850 S Health Parkway
Three Rivers, MI 49093-8358

Phone

(269) 279-5240

Fax

(269) 273-9060

NPI assigned

Sep 20, 2021

Last updated

Nov 25, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Rivers Health System IncGroup PAC ID 8729245584, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Three Rivers Health System, Inc

  dba Three Rivers Health Family Care White Pigeon

  • Rural Health Clinic/Center
  • White Pigeon, MI
  • NPI 1720350903
  Medicare reassignment Care Compare group NPD
• Three Rivers Health System, Inc

  dba Three Rivers Health Infectious Disease

  • Infectious Disease Physician
  • Three Rivers, MI
  • NPI 1346874070
  NPD
• Three Rivers Health System, Inc

  dba Three Rivers Health

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  NPD
• Three Rivers Health

  dba Three Rivers Health Internal Medicine

  • Internal Medicine Physician
  • Three Rivers, MI
  • NPI 1346224367
  NPD (past)

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

• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• Three Rivers Health System, Inc

  dba Three Rivers Health

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  Care Compare affiliation

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1417627589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S HEALTH PARKWAY",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938358",
            "telephone_number": "269-279-5240",
            "fax_number": "269-273-9060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 6th Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490938378",
            "country_code": "US",
            "telephone_number": "269-273-9782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704299077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417627589",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nyla J Schwartz, P.A.
• Andrea N Scott, MSW
• Kimberly Searing, N.P.
• Jason Sears, PHARMD
• Mary Shanahan
• Brooke Sherman-Bailey, MFT
• Kiara Barnes Shields
• Paul James Simpson, DO
• Kaitlynn Nichole Smith
• Mark L Smith

• Family Nurse Practitioner in Three Rivers, MI
• Providers in Three Rivers, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.