BRIAN D. SHAW (CM) – Clinical Social Worker, NPI 1396949517

BRIAN D. SHAW (CM) is a healthcare provider. based in Wynne, Arkansas. specializing in Clinical Social Worker. They hold the professional credentials CM. They hold a License No. 5606C (AR). The NPI Number for BRIAN D. SHAW (CM) is 1396949517

Main info

Male
Sole Proprietor
19 Years Of Experience
Name
BRIAN D. SHAW (CM)
NPI
1396949517
Phone
(870) 208-8499
Address
204 MISSISSIPPI ST S
Enumeration Date
12 June 2007
Last Update Date
30 December 2014

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
2007 (19 years ago)
PAC ID
7911220462
Professional Enrollment ID
I20150108001434
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for BRIAN D. SHAW (CM)

  • 204, Mississippi Street South, Wynne, Cross County, Arkansas, 72396, United States

    WYNNE, AR 723963025

    Phone: (870) 208-8499

    Fax: (870) 208-8044

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-01-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150108001434IClinical Social WorkerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72396)

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Reviews

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Frequently asked questions

What is the registry number for BRIAN D. SHAW (CM)?
The registry entry for BRIAN D. SHAW (CM) shows NPI 1396949517.
Should I treat BRIAN D. SHAW (CM) as an active provider?
Patients and plans typically see BRIAN D. SHAW (CM) as active in the national extract.
What type of care does BRIAN D. SHAW (CM) provide?
BRIAN D. SHAW (CM)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Which community is linked to BRIAN D. SHAW (CM)?
BRIAN D. SHAW (CM) shows a connection to Wynne, Arkansas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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