Susan M Shaw, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000556A Issued in IN

Practice address

3838 N 1St Ave
Ste C
Evansville, IN 47710-3326

Phone

(812) 402-8808

NPI assigned

Apr 19, 2007

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

Other identifiers 4

Other names 1

• Susan M Shaw Harrison Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: susan.shaw-harrison.1@7598.direct.athenahealth.com

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.

• Family Medicine Associates-Southern Indiana , P.C.

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1932128113
  NPD (past)
• St. Mary'S Health, Inc

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1609093772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13059",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N 1ST AVE",
            "address_2": "STE C",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103326",
            "telephone_number": "812-402-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000556A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000543000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "200859330E",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "250470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200406290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SHAW HARRISON",
            "middle_name": "M",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eman O Shahin, LCSW
• Stuart Henry Shake, O.D.
• Andrew Dean Sharp, O.D.
• Taylor Sharp
• Anita C. Shaw, MSW
• Erin Elizabeth Sheeley, COTA
• Andrea G Sheffer, OTR
• Douglas William Sheffer, MD
• Shelbie Auberry Consulting LLC
• Schelle R Shelby, CST

• Family Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.