EMILY BETSILL SHAW – Family Nurse Practitioner, NPI 1417790338

Family Nurse Practitioner

EMILY BETSILL SHAW is a healthcare provider. based in Zebulon, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN297863 (GA). The NPI Number for EMILY BETSILL SHAW is 1417790338

Main info

Female

2 Years Of Experience

Accepts Medicare Assignment

Name

EMILY BETSILL SHAW

NPI

1417790338

Phone

(678) 588-2232

Address

527 LIFSEY SPRINGS RD

Enumeration Date

18 June 2024

Last Update Date

9 October 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7068461202

Graduation Year

2024 (2 years ago)

PAC ID

2860920949

Group Practice PAC ID

4789913328

Professional Enrollment ID

I20250117000228

Address ID

GA302866209TH502XXSTXX400

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience26

Completeness85

Years active:1State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for EMILY BETSILL SHAW

527 LIFSEY SPRINGS RD
ZEBULON, GA 302956555
Phone: (678) 588-2232
Type: Mailing
502 W MAIN ST
THOMASTON, GA 302866209
Phone: (706) 938-4483
Type: Location

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: 2025-01-17

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

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20250117000228	I	Nurse Practitioner	GA	TBD

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 30295)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4789913328View full group profile