Individual provider Active NPI

Julie Allison Shaw, PA-C

  • Physician Assistant
  • Rome, GA
National Provider Identifier
1982465720
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12096 Issued in GA
Practice address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone
(762) 235-2495
Fax
(706) 238-8013
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12096 GA Primary

Addresses

Primary practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address julie.shaw.1@1498.direct.athenahealth.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240319000355 GA Practitioner - Physician Assistant 4981041571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians

Practice addresses (Care Compare)

101 Redmond Rd
Rome, GA 30165-1535
Phone (762) 235-1760

1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (762) 235-2495

504 Redmond Rd NW
Rome, GA 30165-1416
Phone (762) 235-3130

550 Redmond Rd NW
Rome, GA 30165-1416
Phone (762) 235-3340

855 Curtis Pkwy SE
Calhoun, GA 30701-3688
Phone (706) 624-5180

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Current Accepting new patients
Harbin Clinic, LLC CurrentSince Feb 26, 2024 Accepting new patients

Locations

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

Interoperability endpoints

  • Direct secure messaging: jshaw3005268@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: julie.shaw.1@1498.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1982465720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "762-235-2495",
            "fax_number": "706-238-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JULIE",
        "middle_name": "ALLISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julie.shaw.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1825 Martha Berry Blvd NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.