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Laquanta S Shaw , NON TYPICAL

Driver β€’ Indianapolis, IN

Active NPI 1730735903 Individual Practitioner Female Practitioner
Practice location in NPPES

4160 Tahoe Ct
Indianapolis, IN 462358823

Call 3176278590 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4160 Tahoe Ct

Indianapolis, IN 462358823

Telephone 3176278590
Organization at the Same NPPES Address or Phone
Good Life Home Care Llc Facility NPI 1417888066

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Indianapolis and Indiana

54 active clinicians are listed under Driver with a practice address in Indianapolis, IN (130 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Indianapolis

0% of these 54 clinicians have the CMS telehealth indicator.

0% of these 54 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-16
Driver Primary Specialty

NUCC Taxonomy Code: 172A00000X

License # reported to NPPES IN 2350-45-6933

A person employed to operate a motor vehicle as a carrier of persons or property.

Home Health Aide

NUCC Taxonomy Code: 374U00000X

License # reported to NPPES IN HHA0901819

A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
152957 (IN)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Business Mailing Address November 29, 2022

Registered at 55 S STATE AVE STE 353, INDIANAPOLIS, IN 462013890 (Tel: 3176278590)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 29, 2022

Home Health Aide (license number reported to NPPES: IN HHA0901819)

βœ…
NPI Profile Active August 14, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 14, 2019

Registered at 4160 TAHOE CT, INDIANAPOLIS, IN 462358823 (Tel: 3176278590)

πŸ“
Business Mailing Address (Initial Record) August 14, 2019

Registered at 4160 TAHOE CT, INDIANAPOLIS, IN 462358823 (Tel: 3176278590)

πŸ‘€
Provider Name / Credentials (Initial Record) August 14, 2019

Recorded as LAQUANTA SHAW, NON TYPICAL

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2019

Driver (license number reported to NPPES: IN 2350-45-6933)

🟒
Initial NPI Registration & Enumeration August 14, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1730735903
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 14, 2019
Last Update: September 16, 2025
Sole Proprietor: No

Mailing Address

55 S State Ave Ste 353

Indianapolis, IN 462013890

Phone: 3176278590

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.