Active NPI
Ricki Marita Shaw, ACNP
- Acute Care Nurse Practitioner
- Greenville, SC
National Provider Identifier
1417766973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 29614
- Practice address
- 2106 Woodruff Rd
Greenville, SC 29607-6944 - Phone
- (864) 520-9115
- NPI assigned
- Dec 30, 2024
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 29614 | SC | Primary |
Addresses
Primary practice location
2106 Woodruff Rd
Greenville, SC 29607-6944
Mailing address
2 Furman St
Greenville, SC 29611-4709
Phone (864) 520-3054
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 |
|---|---|---|---|
| 29614 | SC | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762992000000",
"number": "1417766973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 FURMAN ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296114709",
"telephone_number": "864-520-3054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 WOODRUFF RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296076944",
"telephone_number": "864-520-9115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "RICKI",
"middle_name": "MARITA",
"credential": "ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-30",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "SC",
"license": "29614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.