Active NPI
Karen J Shaw, MSN, APRN, BC
- Adult Psychiatric/Mental Health Registered Nurse
- Brighton, MA
National Provider Identifier
1619913332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 93017
- Practice address
- 63 Dunboy St
Brighton, MA 02135-1737 - Phone
- (617) 513-5575
- NPI assigned
- Jun 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 93017 | MA | |
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 93017 | MA | Primary |
Addresses
Primary practice location
63 Dunboy St
Brighton, MA 02135-1737
Mailing address
63 Dunboy St
Brighton, MA 02135-1737
Phone (617) 513-5575
Other practice location 1
10 Gove St
East Boston, MA 02128-1920
Phone (617) 565-5800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93017 | Other | MA | ADULT PSYCHIATRIC CLINICAL NURSE SPECIALIST- BOARD CERTIFIED |
| 93017 | Other | MA | RN LICENSE |
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
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93017 | MA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1619913332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 DUNBOY ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021351737",
"telephone_number": "617-513-5575",
"fax_number": "617-254-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 DUNBOY ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021351737",
"telephone_number": "617-513-5575"
}
],
"practiceLocations": [
{
"address_1": "10 Gove St",
"address_purpose": "LOCATION",
"city": "East Boston",
"state": "MA",
"postal_code": "021281920",
"country_code": "US",
"telephone_number": "617-565-5800",
"fax_number": "617-568-4756",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAW",
"first_name": "KAREN",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "MSN, APRN, BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-21",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MA",
"license": "93017",
"primary": false
},
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "MA",
"license": "93017",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADULT PSYCHIATRIC CLINICAL NURSE SPECIALIST- BOARD CERTIFIED",
"identifier": "93017",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "93017",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.