NICOLE B SHAW (NPI# 1346614138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346614138 |
| Entity Type | Individual |
| Full Name | NICOLE B SHAW |
| Credential | NP |
| Practice Address |
11141 Parkview Plaza Dr Ste 305 Fort Wayne IN 46845-1715 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2602668907 |
| Practice Fax Number | 2604256789 |
| Mailing Telephone | 2602666013 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2017-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71005611A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | REGISTERED NURSE LICENSE | 28202395A | 01 |
| IN | FAMILY NURSE PRACTITIONER LICENSE | F0714303 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1255 Engle St, Huntington, IN 467503927 | 2603550722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457701005 | Nicole M Shaw | Physical Therapist | 3100 Colony Dr, Alliance, OH 44601-5244 | 2016-06-14 |
| 1316277593 | Nicole Levarsette Shaw | Pharmacy Technician | 1602 Princeton Ln, Augusta, GA 30904-5070 | 2010-01-11 |
| 1356989966 | Nicole Danielle Shaw | Behavioral Analyst | 1400 Fox Hill Rd Ste 100, State College, PA 16803-1877 | 2019-12-13 |
| 1295297497 | Nicole Shaw | Psychiatry & Neurology | 5841 S Maryland Ave # Mc1052, Chicago, IL 60637-1443 | 2019-04-05 |
| 1023572997 | Nicole Shaw | Speech-Language Pathologist | 4500 E Cherry Creek South Dr Ste 710, Denver, CO 80246-1534 | 2019-01-25 |
| 1386151850 | Nicole Shaw | Physical Therapist | 185 Harrison Ave, Boston, MA 02111-1804 | 2018-01-05 |
| 1861910549 | Nicole Shaw | Counselor | 2450 E Fort Union Blvd, Cottonwood Heights, UT 84121-3337 | 2017-09-01 |
| 1801253703 | Nicole Shaw | Counselor | 847 Ne 19th Ave, Portland, OR 97232 | 2016-01-22 |
| 1285079020 | Nicole Shaw | Family Medicine | 1890 Al Highway 157 Ste 300, Cullman, AL 35058-0689 | 2013-05-07 |
| 1568704039 | Nicole Leanne Shaw | Case Manager/Care Coordinator | 2001 The Alameda, San Jose, CA 95126-1136 | 2013-03-22 |
| Street Address |
11141 PARKVIEW PLAZA DR STE 305 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194726950 | Raymond A. Cava | Surgery | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2005-08-02 |
| 1497361927 | Amanda Renee Macias | Registered Nurse | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2020-09-21 |
| 1093278509 | Julianne E. Hunter | Registered Nurse | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2019-04-11 |
| 1235699521 | Danielle M Kammer | Registered Nurse | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2019-03-22 |
| 1467944892 | Megan Weber | Registered Nurse | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845 | 2018-06-01 |
| 1710387121 | Amy Pond | Physician Assistant | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845 | 2014-09-04 |
| 1396022489 | Matthew Pfister | Surgery | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2011-11-03 |
| 1770866808 | Megan E. Goetz | Nurse Practitioner | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845 | 2011-09-26 |
| 1841581931 | Sarah Yue Wang | Internal Medicine | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2011-04-25 |
| 1770801193 | Kristin Danielle Hummel | Surgery | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2010-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394599 | Laury Farrell | Nurse Practitioner | 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 | 2020-10-22 |
| 1730787599 | Crystal Neal | Nurse Practitioner | 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 | 2020-10-14 |
| 1225668312 | Kathleen Vanderreyden | Nurse Practitioner | 3005 E State Blvd, Fort Wayne, IN 46805-4736 | 2020-01-17 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1275980690 | April Anderson | Nurse Practitioner | 6920 Pointe Inverness Way Ste 120, Fort Wayne, IN 46804-7926 | 2016-05-16 |
| 1922470970 | Jennifer Carol Littke | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2015-10-28 |
| 1275956054 | Andrea N Lahrman | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 106, Fort Wayne, IN 46845-1707 | 2014-01-29 |
| 1417213729 | Laura Beth Baker | Nurse Practitioner | 5750 Falls Drive, Fort Wayne, IN 46804-7147 | 2012-04-11 |
| 1447572441 | Kathryn L Smith | Nurse Practitioner | 11104 Parkview Circle Dr Ste 20, Fort Wayne, IN 46845-1733 | 2010-02-18 |
| 1316180144 | Braden M Butterfield Mckinley | Nurse Practitioner | 2101 E Coliseum Blvd Rm 234, Fort Wayne, IN 46805-1445 | 2009-04-09 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.