Individual provider

Jessica Shaw, AGACNP-BC

Family Nurse Practitioner Neuroscience Registered Nurse Acute Care Nurse Practitioner Medicare enrolled

Jessica Shaw, AGACNP-BC is a Family Nurse Practitioner in Fort Worth, TX, registered under NPI 1417969429. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 800 W MAGNOLIA AVE, Fort Worth, TX 76104. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

800 W MAGNOLIA AVE, Fort Worth, TX 76104 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
AP132391 TX Family Nurse Practitioner primary
637618 TX Neuroscience Registered Nurse
AP132391 TX Acute Care Nurse Practitioner

This provider holds licence AP132391 issued in TX. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Nurse Practitioner
PAC ID
5597184648
Enrollment ID
I20200923002027

Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Family covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363LF0000X Family Nurse Practitioner Family AP132391 TX primary
163WN0800X Neuroscience Registered Nurse Neuroscience 637618 TX
363LA2100X Acute Care Nurse Practitioner Acute Care AP132391 TX

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1417969429 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateAug 12, 2006
Last updatedFeb 5, 2025
StatusActive
Sole proprietorNo
CredentialAGACNP-BC
Practice address 800 W MAGNOLIA AVE
Fort Worth, TX 76104
(817) 759-7000
Fax (817) 759-7027
Mailing address 2705 5TH AVE
Fort Worth, TX 76110
This record was updated on Feb 5, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1417969429 passes the NPI check digit test The final digit 9 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 4 1 7 9 6 9 4 2
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 4 2 7 9 6 9 4 4

Sum = 71 · next multiple of 10 = 80 · check digit = 9 · actual last digit = 9

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1417969429?
NPI 1417969429 is the National Provider Identifier assigned to Jessica Shaw, AGACNP-BC in Fort Worth, TX. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Family cover?
Definition to come...
How do I contact Jessica Shaw, AGACNP-BC?
The phone number on file with NPPES is (817) 759-7000, last updated Feb 5, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Jessica Shaw, AGACNP-BC accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1417969429 a valid number?
Yes. 1417969429 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.