Individual provider Active NPI

Tera Marie Shaw, APRN

  • Acute Care Nurse Practitioner
  • West Milton, OH
National Provider Identifier
1760166904
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.0034001 Issued in OH
Practice address
407 N. Miami St
West Milton, OH 45383
Phone
(937) 430-2213
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0034001 OH Primary

Addresses

Primary practice location

407 N. Miami St
West Milton, OH 45383

Mailing address

407 N Miami St
West Milton, OH 45383-1911
Phone (937) 430-2213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230925003148 OH Practitioner - Nurse Practitioner 5698129690 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Care Group PCGroup PAC ID 7416107487, 29 clinicians

Practice addresses (Care Compare)

835 Sweitzer St
Greenville, OH 45331-1007
Phone (260) 344-4035

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0034001OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Sep 11, 2023 Accepting new patients
Sinclair Physician Services, LLC CurrentSince Oct 1, 2024 Accepting new patients
Hospital Care Group, P.C. CurrentSince Mar 18, 2025 Accepting new patients
Hisey Physician Services, LLC CurrentSince Sep 1, 2024 Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 11, 2023 Accepting new patients
Hospital Medicine Services of Ohio, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Premier Health Specialists Inc Current Accepting new patients

Locations

3955 W Washington Center Rd
Fort Wayne, IN 46818
Phone (260) 800-3601

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

835 Sweitzer St
Greenville, OH 45331
Phone (937) 548-1141

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045

45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1760166904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N MIAMI ST",
            "city": "WEST MILTON",
            "state": "OH",
            "postal_code": "453831911",
            "telephone_number": "937-430-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N. MIAMI ST",
            "city": "WEST MILTON",
            "state": "OH",
            "postal_code": "45383",
            "telephone_number": "937-430-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TERA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0034001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Milton, OH

Sources for this page

Verify at the official NPI Registry.