Active NPI
Marsha Diane Shaw, CRNP
- Nurse Practitioner
- Tuscaloosa, AL
National Provider Identifier
1487675146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1-020751
- Practice address
- 200 University Blvd
Tuscaloosa, AL 35401-1250 - Phone
- (205) 759-0407
- Fax
- (205) 759-0845
- NPI assigned
- Jul 21, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-020751 | AL | Primary |
Addresses
Primary practice location
200 University Blvd
Tuscaloosa, AL 35401-1250
Mailing address
200 University Blvd
Tuscaloosa, AL 35401-1250
Phone (205) 759-0407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00104410 | Other | R/R GROUP |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-020751 | AL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487675146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 UNIVERSITY BLVD",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354011250",
"telephone_number": "205-759-0407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UNIVERSITY BLVD",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354011250",
"telephone_number": "205-759-0407",
"fax_number": "205-759-0845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "MARSHA",
"middle_name": "DIANE",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1-020751",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R/R GROUP",
"identifier": "P00104410",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.