Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396513719 Individual Practitioner Male Practitioner

Jacob R Shaw

Peer Specialist • Basin, WY

Professional Overview & Biography Verified Profile Summary

Jacob Shaw is a registered healthcare professional specializing in Peer Specialist in Basin, WY. Practice services are available at 116 SOUTH 3RD STREET under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

116 South 3rd Street

Basin, WY 82410

Telephone 3075682020
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Basin, WY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Basin, WY (89 Statewide)

Telehealth Adoption Rate
0.0% 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: 2023-12-13
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License WY 143

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

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

7 Associated Practitioners
Anja Louis

Case Manager/Care Coordinator

NPI 1023628542
Dr. Ralph Louis , PhD

Psychologist - Clinical

NPI 1225256027

Doctor of Philosophy (Ph.D.)

Rebecca Myers

Counselor - Addiction (Substance Use Disorder)

NPI 1386391209
Darwin Irvine , MA, LPC, LAT

Counselor - Mental Health

NPI 1417285883

Master of Arts, Licensed Professional Counselor, Licensed Athletic Trainer

Deborah Franko Lane , RN

Registered Nurse - Psychiatric/Mental Health, Adult

NPI 1679739213

Registered Nurse

Julie Oster , MS, LPC

Counselor - Professional

NPI 1871740118

Master of Science, Licensed Professional Counselor

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active December 14, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location December 14, 2023

Registered at 116 SOUTH 3RD STREET, BASIN, WY 82410 (Tel: 3075682020)

📍
Updated Business Mailing Address December 14, 2023

Registered at 1114 LANE 12, LOVELL, WY 824319555 (Tel: 3075486543)

👤
Provider Name / Credentials Updated December 14, 2023

Recorded as JACOB SHAW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 14, 2023

Peer Specialist (License #143 in WY)

🟢
Initial NPI Registration & Enumeration December 14, 2023

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 Jacob Shaw. Be the first to share your experience!

Sign in to leave a review for Jacob Shaw

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

NPI Administrative Meta

NPI Number: 1396513719
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 14, 2023
Last Update: December 14, 2023
Sole Proprietor: No

Mailing Address

1114 Lane 12

Lovell, WY 824319555

Phone: 3075486543

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.