Bradley J Shaw, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP022269 Issued in PA

Practice address

216 N 2ND St Ste 5
Clearfield, PA 16830-2547

Phone

(814) 205-4025

Fax

(814) 240-6632

NPI assigned

Jul 5, 2017

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

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Still Waters Mental Health Services LLCGroup PAC ID 4284052143, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Still Waters Mental Health Services, LLC

  • Multi-Specialty Clinic/Center
  • Clearfield, PA
  • NPI 1659991594

  Family

  Medicare reassignment Care Compare group NPD Authorized official
• Dubois Regional Medical Center

  • General Acute Care Hospital
  • Du Bois, PA
  • NPI 1144249657
  NPD (past)

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1942721592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N 2ND ST STE 5",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168302547",
            "telephone_number": "814-205-4025",
            "fax_number": "814-240-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N 2ND ST STE 5",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168302547",
            "telephone_number": "814-205-4025",
            "fax_number": "814-240-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP022269",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Schreckengost, NP-C
• John Scott Schuster, MSW/ LCSW
• Scott R. Strauss, D.O.
• Kevin Thomas Scott, CRNP
• Varun Sharma, MD
• Mandie L Shaw, CRNP
• Ashley Shearer, NP-C
• Connor Scott Shirey, DPT
• Brittney Shoenfelt
• Ashley Chylynn Shugarts, LPN

• Psychiatric/Mental Health Nurse Practitioner in Clearfield, PA
• Providers in Clearfield, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.