Individual provider Active NPI

Stephanie Marie Shaw

  • Case Manager/Care Coordinator
  • Palm Springs, CA
National Provider Identifier
1770775371
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
400 S El Cielo Rd
Suite E/F
Palm Springs, CA 92262-7926
Phone
(760) 416-1753
Fax
(760) 416-0263
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

400 S El Cielo Rd
Suite E/F
Palm Springs, CA 92262-7926

Mailing address

400 S El Cielo Rd
Suite E/F
Palm Springs, CA 92262-7926
Phone (760) 416-1753

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1770775371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S EL CIELO RD",
            "address_2": "SUITE E/F",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922627926",
            "telephone_number": "760-416-1753",
            "fax_number": "760-416-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S EL CIELO RD",
            "address_2": "SUITE E/F",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922627926",
            "telephone_number": "760-416-1753",
            "fax_number": "760-416-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.