Individual provider Active NPI

Robert Shaw, CNP

  • Psychiatry Physician
  • Adrian, MI
National Provider Identifier
1962240184
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
APRN.CNP.0036827 Issued in MI
Practice address
142 E Maumee St
Adrian, MI 49221-2735
Phone
(571) 263-5810
NPI assigned
Jul 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X APRN.CNP.0036827 MI Primary

Addresses

Primary practice location

142 E Maumee St
Adrian, MI 49221-2735

Mailing address

142 E Maumee St Ste 3
Adrian, MI 49221-2735
Phone (517) 263-5810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250308000197 MI Practitioner - Nurse Practitioner 3476074303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Acpc PLLCGroup PAC ID 4981947850, 19 clinicians

Practice addresses (Care Compare)

142 E Maumee St
Suite 3
Adrian, MI 49221-2735
Phone (517) 263-5810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0036827MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acpc PLLC CurrentSince Dec 29, 2024 Accepting new patients

Locations

142 E Maumee St
Ste 3
Adrian, MI 49221
Phone (517) 263-5810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1962240184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 E MAUMEE ST STE 3",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212735",
            "telephone_number": "517-263-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E MAUMEE ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212735",
            "telephone_number": "571-263-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROBERT",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "APRN.CNP.0036827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.