Active NPI
Jo Shaw, PH.D.
- Clinical Psychologist
- Honolulu, HI
National Provider Identifier
1487271037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY-1853
- Practice address
- 1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404 - Phone
- (310) 431-9047
- NPI assigned
- Jun 30, 2020
- Sex
- Female
- 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 Psychologist | 103TC0700X | PSY-1853 | HI | Primary |
Addresses
Primary practice location
1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404
Mailing address
2 Williams St
Edwardsville, PA 18704-1706
Phone (310) 426-0399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201221002741 | HI | Practitioner - Clinical Psychologist | 6800216730 | Practice locations: Honolulu, HI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-1853 | HI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1487271037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WILLIAMS ST",
"city": "EDWARDSVILLE",
"state": "PA",
"postal_code": "187041706",
"telephone_number": "310-426-0399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BISHOP ST STE 2685A",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968133404",
"telephone_number": "310-431-9047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JO",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-30",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "PSY-1853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.