Justine Renae Shaw

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

237789 Issued in AR

Practice address

4055 Valley View LN
Dallas, TX 75244-5074

Phone

(855) 984-5121

NPI assigned

Jun 9, 2026

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 names 1

• Justine Renae Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1417881202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CHALLAIN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235517",
            "telephone_number": "903-245-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "855-984-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JUSTINE",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "237789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "SMITH",
            "middle_name": "RENAE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Holly Shaw
• Jason Shaw, LCSW
• Jill Rodriguez Shaw
• Joseph A. Shaw, M.A., LPC
• Joshua Shaw
• Karyn Shaw, RD, LD
• Katrina Shaw, RPH
• Lindsay Fowler Shaw
• Lou Shaw, B.A.
• Marissa Shaw

• Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.