Individual provider Active NPI

Jessica Lori Shaw, PT

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1689670895
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6258 Issued in TN
Practice address
2415 McCallie Ave
Chattanooga, TN 37404-3322
Phone
(423) 622-6200
Fax
(423) 697-2025
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT007002 GA
Physical Therapist 225100000X 6258 TN Primary

Addresses

Primary practice location

2415 McCallie Ave
Chattanooga, TN 37404-3322

Mailing address

2415 McCallie Ave
Chattanooga, TN 37404-3322
Phone (423) 622-6200

Other identifiers 2

IdentifierTypeStateIssuer
4021800OtherTNBCBS
TN0100OtherTNJOHN DEERE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000141 TN Practitioner - Physical Therapist in Private Practice 9830119015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 N Ocoee St
Cleveland, TN 37311-3854
Phone (423) 624-2696

2415 McCallie Ave
Chattanooga, TN 37404-3322
Phone (423) 624-2696

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007002GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Orthopaedic Group, PC CurrentSince May 1, 2006 Accepting new patients
Chattanooga Orthopaedic Group PC Physical Therapist CurrentSince May 1, 2006 Accepting new patients
Chattanooga Orthopaedic Group, PC Physical Therapist PastSince May 11, 2025 Accepting new patients
Chattanooga Orthopaedic Group, PC Past Accepting new patients
Chattanooga Orthopaedic Group, PC Physical Therapist Past Accepting new patients
Chattanooga Orthopaedic Group, PC Physical Therapist Past Accepting new patients

Locations

4725 Battlefield Pkwy
Ringgold, GA 30736

7305 Jarnigan Rd
Ste 280
Chattanooga, TN 37421

2415 McCallie Ave
Chattanooga, TN 37404
Phone (423) 629-4395

6401 Lee Hwy
Ste 109
Chattanooga, TN 37421
Phone (423) 713-5639

2400 N Ocoee St
Cleveland, TN 37311
Phone (423) 476-5547

2399 Parker St NE
Ste C3
Cleveland, TN 37311
Phone (423) 697-8844

2051 Hamill Rd
Ste 3000
Hixson, TN 37343

Interoperability endpoints

  • Direct secure messaging: jessica.shaw.1@519.direct.athenahealth.com

Organizations & group practices 6

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1689670895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043322",
            "telephone_number": "423-622-6200",
            "fax_number": "423-697-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043322",
            "telephone_number": "423-622-6200",
            "fax_number": "423-697-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JESSICA",
        "middle_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007002",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "6258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4021800",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0100",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.