Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1942454186 Individual Practitioner Female Practitioner

Kimberly Danielle Shaw , PA-C

Physician Assistant • Harvey, IL

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Kimberly Shaw, PA-C is a registered healthcare professional specializing in Physician Assistant in Harvey, IL. Official NPI practice address is registered at 31 W 155TH ST.

Practice Location & Contact Primary Location

Practice Address

31 W 155th St

Harvey, IL 604263556

Telephone 7085965177
Fax 7085965518
Associated Practice Facility / Clinic
🏢 J And M Pharmacy Inc Facility NPI 1386686970

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Harvey, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.8 Yrs
State Avg: 11.7 Yrs
Regional Practice Density
12 Specialists

Practicing in Harvey, IL (4958 Statewide)

Telehealth Adoption Rate
8.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-07-18
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085-003355

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
085003355 (IL)
Commercial Insurance / Payer ID Bcbs
01616617 (IL)

Secondary Practice Locations

3201 S Wallace St

Chicago, IL 606163501

Phone: 3123261615

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Maira Ochoa , APN

Nurse Practitioner - Family

NPI 1003303769

Advanced Practice Nurse

Mia Webster-Cross , RN, BSN

Registered Nurse - Administrator

NPI 1013406180

Registered Nurse, Bachelor of Science in Nursing

NPI 1033353792

Doctor of Osteopathic Medicine (D.O.)

Yvette Johnson , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1043608631

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Beryl Armstrong , LCPC

Counselor - Professional

NPI 1043755697

Licensed Clinical Professional Counselor

NPI 1053020107

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location July 13, 2021

Registered at 31 W 155TH ST, HARVEY, IL 604263556 (Tel: 7085965177)

📍
Updated Business Mailing Address July 13, 2021

Registered at 31 W 155TH ST, HARVEY, IL 604263556 (Tel: 7085965177)

NPI Profile Active November 14, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location November 14, 2008

Registered at 3201 S WALLACE ST, CHICAGO, IL 606163501 (Tel: 3123261615)

📍
Updated Business Mailing Address November 14, 2008

Registered at 20110 GOVERNORS HWY, OLYMPIA FIELDS, IL 604611030 (Tel: 7087477960)

👤
Provider Name / Credentials Updated November 14, 2008

Recorded as KIMBERLY SHAW, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2008

Physician Assistant (License #085-003355 in IL)

🟢
Initial NPI Registration & Enumeration November 14, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Kimberly Shaw. Be the first to share your experience!

Sign in to leave a review for Kimberly Shaw

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1942454186
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 14, 2008
Last Update: July 18, 2024
Sole Proprietor: No

Mailing Address

31 W 155th St

Harvey, IL 604263556

Phone: 7085965177

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.