Gwendolyn Earlene Shaw, BA, MHS, LSW, CMHT

Primary specialty

School CounselorTaxonomy code 101YS0200X

Practice address

152 Highway 7 S
Oxford, MS 38655

Phone

(662) 234-7521

Fax

(662) 236-3071

NPI assigned

Jun 6, 2018

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 MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Mississippi Commission on Mental Illness/Mental RetardationGroup PAC ID 6103084041, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

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.

• North Mississippi Commission on Mental Illness/Mental Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oxford, MS
  • NPI 1558468694
  Medicare reassignment Care Compare group NPD
• North Mississippi Commission on Mental Illness/Mental Retardation

  • Primary Care Clinic/Center
  • Oxford, MS
  • NPI 1376208173
  NPD

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1578055489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555392",
            "telephone_number": "662-234-7521",
            "fax_number": "662-236-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-234-7521",
            "fax_number": "662-236-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "GWENDOLYN",
        "middle_name": "EARLENE",
        "credential": "BA, MHS, LSW, CMHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Shackleford, M.A.
• Dhairya Miteshkumar Shah
• Parth Jay Shah
• Anna Kathryn Sharp
• Crystal Shaw, FNP
• Joian Shaw
• Mary Shaw, M.ED.
• Tacara Shaw, BS
• Bryson Carter Sheffield
• Leslie Dawn Sheffield, FNP-C

• School Counselor in Oxford, MS
• Providers in Oxford, MS by specialty
• School Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.