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SHAW FAMILY MEDICAL
NPI 1750642633
Clinic/Center in Shaw, MS

Active since June 06, 2012
112 W PEELER AVE, SHAW, MS 38773(662) 754-3301(662) 754-3304 Get Directions Write a Review

NPPES record last updated: February 22, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1750642633
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSHAW FAMILY MEDICAL, LLC
Location Address112 W PEELER AVEShaw, MS 38773-8710
Mailing AddressPo Box 299Shaw, MS 38773-0299 · (662) 754-3301 · Fax (662) 654-3304
Phone(662) 754-3301
Fax(662) 754-3304
Organization SubpartNo
Authorized OfficialNora Gough-davisPartner · (662) 754-3301
Enumeration DateJune 6, 2012
Last NPPES UpdateFebruary 22, 2017
✔ NPI 1750642633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
112 W PEELER AVE, Shaw, MS 38773
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Other Names 1

Doing Business AsShaw Family Medical

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERESA WILSON NP
Nurse Practitioner (Adult Health)
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 754-3301
KIMBERLY ROBINSON FNP-C
Nurse Practitioner (Primary Care)
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 754-3301
MRS. WILLIE MARY BOLDEN
Nurse Practitioner (Family)
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 745-6638
MRS. REGINA JONELLE EVANS FNP
Nurse Practitioner (Family)
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 754-3301
NORA CECELIA GOUGH-DAVIS FNP
Nurse Practitioner (Family)
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 754-3301
KIM DAVIS NP
Family Medicine
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 754-3301
CLIFTON DEWAYNE REED
Nurse Practitioner (Family)
112 W PEELER AVE
SHAW, MS 38773
Bolivar County (662) 754-3304

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.

What insurance does Shaw Family Medical, LLC accept?

Health plans from Molina Healthcare 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.