SHAW FAMILY MEDICAL
NPI 1750642633
Clinic/Center in Shaw, MS
About Shaw Family Medical NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAW FAMILY MEDICAL (NPI 1750642633) is a healthcare organization registered as a clinic/center in Shaw, Mississippi and active in the NPI registry since June 2012. The organization lists Nora Gough-davis, Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shaw Family Medical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Shaw Family Medical, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Shaw Family Medical, LLC's NPI number?
The NPI number for Shaw Family Medical, LLC is 1750642633. It was assigned to this organization in the NPPES registry on June 6, 2012. The provider is doing business as Shaw Family Medical.
Where is Shaw Family Medical, LLC located?
Shaw Family Medical, LLC is located at 112 W Peeler Ave, Shaw, MS 38773. The listed phone number is (662) 754-3301.
What is Shaw Family Medical, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Shaw Family Medical, LLC enrolled in Medicare?
Yes. Shaw Family Medical, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shaw Family Medical, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Shaw Family Medical, LLC. A 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 the clinician's services. Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Shaw Family Medical, LLC 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 Shaw Family Medical, LLC 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 Shaw Family Medical, LLC was last updated on February 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.
# Shaw Family Medical · NPI 1750642633
Clinic/Center organization in Shaw, Mississippi. Organization record, active in the CMS NPPES registry since June 6, 2012.
## Identity
- **NPI:** 1750642633 (Entity type: Organization)
- **Enumerated:** June 6, 2012
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** Shaw Family Medical, Llc
- **Organization subpart:** No
- **Authorized official:** Nora Gough-Davis, PARTNER
## Practice location
- **Address:** 112 W PEELER AVE, Shaw, MS 38773-8710
- **Phone:** (662) 754-3301 · **Fax:** (662) 754-3304
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 4 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 22, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1750642633) · Data from the CMS NPPES public registry.