Kelly Shaw, DDS is a medicare enrolled "Dentist - General Practice" provider in Newell, West Virginia. Her current practice location is
1151 Washington St, Newell, West Virginia. You can reach out to her office (for appointments etc.) via phone at
(304) 459-4010.
Kelly Shaw is licensed to practice in West Virginia (license number 4352) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457847667.
Healthcare Provider's Profile
| Full Name | Kelly Shaw |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 1151 Washington St, Newell, West Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1457847667
- Provider Enumeration Date: 07/11/2018
- Last Update Date: 04/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 8022361658
- Enrollment ID: I20181030000741
Medical Identifiers
Medical identifiers for Kelly Shaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457847667 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223G0001X | Dentist - General Practice | 4352 (West Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Shaw allows following entities to bill medicare on her behalf.
| Entity Name | Change Incorporated |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245244367
PECOS PAC ID: 1759325327
Enrollment ID: O20050614001275 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Shaw is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kelly Shaw, DDS
1305 Dairy Ln Apt A,
East Liverpool, OH 43920-9766
Ph: (304) 680-0735 | Kelly Shaw, DDS
1151 Washington St,
Newell, WV 26050-1437
Ph: (304) 459-4010 |
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