Active NPI
Michael Shaw, ARNP
- Psychiatric/Mental Health Nurse Practitioner
- Fort Myers, FL
National Provider Identifier
1497765242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- ARNP9220477
- Practice address
- 12550 New Brittany Blvd
Fort Myers, FL 33907-3655 - Phone
- (239) 343-9180
- Fax
- (239) 343-9188
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | ARNP9220477 | FL | Primary |
Addresses
Primary practice location
12550 New Brittany Blvd
Fort Myers, FL 33907-3655
Mailing address
P.O. Box 2147
Cape Coral, FL 33991-2038
Phone (239) 424-1449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 768068600 | Medicaid | FL |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1497765242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 2147",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339912038",
"telephone_number": "239-424-1449",
"fax_number": "239-424-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12550 NEW BRITTANY BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073655",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "ARNP9220477",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "768068600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.