Individual provider Active NPI

Kimberly Dawn Shaw, CNM

  • Advanced Practice Midwife
  • Greensboro, NC
National Provider Identifier
1639241490
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
290 Issued in NC
Practice address
930 3Rd St
Greensboro, NC 27405-6967
Phone
(336) 890-3200
Fax
(336) 890-3290
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 290 NC Primary

Addresses

Primary practice location

930 3Rd St
Greensboro, NC 27405-6967

Mailing address

930 3Rd St
Greensboro, NC 27405-6967
Phone (336) 890-3200

Other practice location 1

801 Green Valley Rd
Greensboro, NC 27408-7021
Phone (336) 832-6614

Other identifiers 1

IdentifierTypeStateIssuer
10643OtherNCACNM CERTIFICATE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kshaw12801@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20050224000854 NC Practitioner - Certified Nurse Midwife (CNM) 9537112073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 379-4307

1200 N Elm St
Greensboro, NC 27401-1020
Phone (336) 574-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Medical Center, PA Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Oct 8, 2016 Accepting new patients
Moses Cone Physician Services, Inc. Current Accepting new patients
Moses Cone Physician Services Inc CurrentSince Oct 1, 2018 Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Piedmont Healthcare for Women Greensboro OB GYN Division Past Accepting new patients
Moses Cone Affiliated Physicians, Inc Past Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1248 Huffman Mill Rd
Ste 101
Burlington, NC 27215
Phone (336) 538-0089

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1041 Kirkpatrick Rd
Ste 100
Burlington, NC 27215
Phone (336) 538-0089

930 3rd St
Greensboro, NC 27405
Phone (336) 610-3720

1200 N Elm St
Ste 5
Greensboro, NC 27401

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

801 Green Valley Rd
Greensboro, NC 27408
Phone (336) 282-4840

3711 Elmsley St
Ste 101
Greensboro, NC 27406
Phone (336) 890-2165

520 Maple Ave
Ste C
Reidsville, NC 27320
Phone (336) 342-6063

Interoperability endpoints

  • Direct secure messaging: kshaw12801@direct.conehealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1639241490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 3RD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056967",
            "telephone_number": "336-890-3200",
            "fax_number": "336-890-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 3RD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056967",
            "telephone_number": "336-890-3200",
            "fax_number": "336-890-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Green Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274087021",
            "country_code": "US",
            "telephone_number": "336-832-6614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACNM CERTIFICATE NUMBER",
            "identifier": "10643",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshaw12801@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "930 3rd St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274056967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.