Individual provider Active NPI

Tamara Shaw, LCSW

  • Clinical Social Worker
  • Ft Carson, CO
National Provider Identifier
1972575421
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.00992687 Issued in CO
Practice address
1650 Cochrane Cir
Ft Carson, CO 80913-4603
Phone
(719) 526-4585
Fax
(719) 526-0608
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 992687 CO
Clinical Social Worker 1041C0700X CSW.00992687 CO Primary

Addresses

Primary practice location

1650 Cochrane Cir
Ft Carson, CO 80913-4603

Mailing address

1650 Cochrane Cir
Ft Carson, CO 80913-4603
Phone (719) 526-4585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603000625 CO Practitioner - Clinical Social Worker 1850779869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
77.43
Improvement activities
40
Cost
70.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
992687COMDMental Health Counselor
CSW.00992687COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks West LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

5822 S Lowell Way
Littleton, CO 80123
Phone (303) 798-2497

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1972575421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-526-4585",
            "fax_number": "719-526-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-526-4585",
            "fax_number": "719-526-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TAMARA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "992687",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.00992687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Carson, CO

Sources for this page

Verify at the official NPI Registry.