Shadreka Shaw

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11020055 Issued in FL

Practice address

1820 Miccosukee Commons Dr
Tallahassee, FL 32308-5432

Phone

(850) 765-8120

NPI assigned

Jun 6, 2022

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Apalachee Center, Inc.

  • Community/Behavioral Health Agency
  • Tallahassee, FL
  • NPI 1548360993
  Medicare reassignment NPD
• Apalachee Center Inc

  • Community/Behavioral Health Agency
  • Apalachicola, FL
  • NPI 1922104017
  NPD
• Florida First Psychiatry Specialist LLC

  • Geriatric Psychiatry Physician
  • Tallahassee, FL
  • NPI 1841754959
  NPD
• Apalachee Center, Inc.

  • Community/Behavioral Health Agency
  • Quincy, FL
  • NPI 1225134513
  NPD (past)
• Apalachee Center, Inc.

  • Community/Behavioral Health Agency
  • Tallahassee, FL
  • NPI 1497325070
  NPD (past)

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1487383568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 ARLINGTON CIR",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323514027",
            "telephone_number": "850-321-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 MICCOSUKEE COMMONS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085432",
            "telephone_number": "850-765-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SHADREKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11020055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Douglas Shaver, NRP
• Heather Shaw Armstrong
• Kasmika Shaw-Gadley, RN
• Gregory Augustine Shaw, ARNP
• Marin Shaw
• Noura H Shaya
• Sandra Renee Sheahon
• Patricia Shealy, PH.D.
• Dana Sheedy, PA-C
• James Brian Sheedy, MD

• Psychiatric/Mental Health Nurse Practitioner in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.

Verify at the official NPI Registry.