KIMBERLY SHAW FNP
NPI 1265104095
Nurse Practitioner - Family in Flowood, MS
About Kimberly Shaw Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY SHAW FNP (NPI 1265104095) is an individual family provider in Flowood, Mississippi, licensed in Mississippi (904933) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Ridgeland.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimberly Shaw Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Kimberly Shaw reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jackson, MS 39203
- Reassigned Medicare billing, Mississippi enrollment
- 3 clinicians in this Medicare group
Ripley, MS 38663
- Reassigned Medicare billing, Mississippi enrollment
- 463 clinicians in this Medicare group
Pembroke Pines, FL 33027
- Reassigned Medicare billing, Mississippi enrollment
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39232 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FLOWOOD, MS 39232
FLOWOOD, MS 39232
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Shaw's NPI number?
The NPI number for Kimberly Shaw is 1265104095. It was assigned to this individual provider in the NPPES registry on September 30, 2021. The provider is also known as Kimberly Moore.
Where is Kimberly Shaw located?
Kimberly Shaw practices at 232 Market St, Flowood, MS 39232. The listed phone number is (866) 849-0692.
What is Kimberly Shaw's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kimberly Shaw enrolled in Medicare?
Yes. Kimberly Shaw is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kimberly Shaw's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Shaw reassigns Medicare benefits to 3 organizations: H E A L Mississippi (Jackson, MS), Fast Pace Mississippi, PLLC (Ripley, MS) and Devoted Medical Group Professional Corporation (Pembroke Pines, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Shaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberly Shaw accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Kimberly Shaw as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kimberly Shaw was last updated on May 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kimberly Shaw, FNP · NPI 1265104095
Family physician in Flowood, Mississippi. Individual provider, active in the CMS NPPES registry since September 30, 2021.
## Identity
- **NPI:** 1265104095 (Entity type: Individual)
- **Enumerated:** September 30, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 904933 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 232 MARKET ST, Flowood, MS 39232-3339
- **Phone:** (866) 849-0692
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): H E A L Mississippi (NPI 1710659453, Jackson, MS); Fast Pace Mississippi, PLLC (NPI 1447769559, Ripley, MS); Devoted Medical Group Professional Corporation (NPI 1245838168, Pembroke Pines, FL) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 21, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1265104095) · Data from the CMS NPPES public registry.