Carly Shaw, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2019026180 Issued in MO

Practice address

4880 NE Goodview Cir
Lees Summit, MO 64064-1996

Phone

(816) 478-4200

Fax

(816) 875-2598

NPI assigned

Aug 5, 2019

Sex

Female

Sole proprietor

Yes

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 MO, KS2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascentist Physicians Group LLCGroup PAC ID 9335143759, 111 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.19 of 100Reported as group

Quality

72.61

Promoting interoperability

100

Improvement activities

30

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carly.shaw.1@12752.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.

• Ascentist Physicians Group, LLC

  • Otolaryngology Physician
  • Lees Summit, MO
  • NPI 1649206319

  KS

  Medicare reassignment Care Compare group NPD
• Metropolitan Pulmonary and Sleep Medicine PC

  • Pulmonary Disease Physician
  • Lees Summit, MO
  • NPI 1952412231
  NPD (past)

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1689229809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 NE RALPH POWELL RD STE B",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642368",
            "telephone_number": "816-478-4200",
            "fax_number": "816-875-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 NE GOODVIEW CIR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641996",
            "telephone_number": "816-478-4200",
            "fax_number": "816-875-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CARLY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019026180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharp Medical Equipment Inc
• Danielle Sharp, DPT, PT
• Kathryn Anne Sharp, LCSW
• Victoria Shatto
• Kristi Shaumeyer, MD
• Kristin Joy Shaw
• Shawnee Mission Medical Center, Inc.
• Mekenna Shea
• Sheila R Jungmeyer DDS,PC
• D'Monika Shelby

• Nurse Practitioner in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.