Individual provider Active NPI

Inquashia Latrice Shaw, MD

  • Pediatrics Physician
  • Oakwood, GA
National Provider Identifier
1962039909
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
96412 Issued in GA
Practice address
4019 Executive Dr
Oakwood, GA 30566-2825
Phone
(770) 533-6500
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 96412 GA Primary

Addresses

Primary practice location

4019 Executive Dr
Oakwood, GA 30566-2825

Mailing address

PO Box 1060
Oakwood, GA 30566-0018
Phone (770) 718-1122

Other practice location 1

155 Professional Dr
Baldwin, GA 30511-4000
Phone (706) 776-2368

Other practice location 2

4095 S Lee St
Buford, GA 30518-3647
Phone (770) 932-8519

Other practice location 3

1270 Friendship Rd
Braselton, GA 30517-5630
Phone (678) 207-4200

Other practice location 4

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 535-3611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914000174 GA Practitioner - Pediatric Medicine 2163886862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of South Carolina School of Medicine, Greenville, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

725 Jesse Jewell Pkwy SE
Suite 110
Gainesville, GA 30501-3836
Phone (770) 535-0191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
96412GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic PC CurrentSince Jul 4, 2023 Accepting new patients
Northeast Georgia Community Physicians LLC CurrentSince Feb 1, 2026 Accepting new patients
The Longstreet Clinic, PC Pediatrics CurrentSince Jul 4, 2023 Accepting new patients

Locations

155 Professional Dr
Baldwin, GA 30511
Phone (706) 776-2368

1270 Friendship Rd
Braselton, GA 30517
Phone (678) 207-4200

4095 S Lee St
Buford, GA 30518
Phone (770) 932-8519

725 Jesse Jewell Pkwy SE
Ste 110
Gainesville, GA 30501
Phone (770) 535-0191

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

4019 Executive Dr
Oakwood, GA 30566
Phone (770) 533-6500

Organizations & group practices 3

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1962039909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305660018",
            "telephone_number": "770-718-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 EXECUTIVE DR",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305662825",
            "telephone_number": "770-533-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "GA",
            "postal_code": "305114000",
            "country_code": "US",
            "telephone_number": "706-776-2368",
            "fax_number": "706-776-2589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4095 S Lee St",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305183647",
            "country_code": "US",
            "telephone_number": "770-932-8519",
            "fax_number": "770-533-4798",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175630",
            "country_code": "US",
            "telephone_number": "678-207-4200",
            "fax_number": "770-533-4771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Jesse Jewell Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013834",
            "country_code": "US",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "INQUASHIA",
        "middle_name": "LATRICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "96412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakwood, GA

Sources for this page

Verify at the official NPI Registry.