NPIMap

Individual provider Active NPI

Courtney Elizabeth Shaw, CNP

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1487316840
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8646 Issued in MN
Practice address
1001 E Superior St Ste 201
Duluth, MN 55802-2228
Phone
(218) 249-3852
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8646 MN Primary

Addresses

Primary practice location

1001 E Superior St Ste 201
Duluth, MN 55802-2228

Mailing address

1001 E Superior St Ste 201
Duluth, MN 55802-2228
Phone (218) 249-3852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211102000566 WI Practitioner - Nurse Practitioner 9537557145 Reassigns benefits to 1 organization
I20211102000651 MN Practitioner - Nurse Practitioner 9537557145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

1001 E Superior St
Suite 201
Duluth, MN 55802-2228
Phone (218) 249-7980

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3900

Hospital & facility affiliations

  • Aspirus St. Luke'S at Home - Home Care - Duluth Home health agency, Duluth, MN, CCN 247098
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8646MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Oct 25, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Oct 25, 2021 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Oct 25, 2021 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1001 E Superior St
Ste L201
Duluth, MN 55802
Phone (218) 249-3057

1000 E 1st St
Ste Ll
Duluth, MN 55805
Phone (218) 249-4700

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1001 E Superior St
Ste 201
Duluth, MN 55802
Phone (218) 249-3057

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

4702 Grand Ave
Duluth, MN 55807
Phone (218) 249-6800

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: cshaw237576@direct.aspirus.org
  • Direct secure messaging: courtney.shaw@slk.direct.slhduluth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1487316840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST STE 201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022228",
            "telephone_number": "218-249-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST STE 201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022228",
            "telephone_number": "218-249-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "COURTNEY",
        "middle_name": "ELIZABETH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.