Bradley W Shaw

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

741 Scholl Rd
Mansfield, OH 44907-1587

Phone

(419) 756-1717

NPI assigned

Oct 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1811715220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SCHOLL RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071587",
            "telephone_number": "419-756-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 SCHOLL RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071587",
            "telephone_number": "419-756-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BRADLEY",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-03",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Shaull
• Rhema Rachelle Shaull
• Ricki Lynn Shaull
• Tammy Shaull
• Alona Shaver
• Charles H Shaw, M.D.
• Colleen Shaw
• Keeley Shaw, COTA/L
• Nancy Shear, BS ED.
• Amber Marie Sheets

• Peer Specialist in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2025; 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.