MEDICARE: RACHEL SHAW-WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	171M00000X	Case Manager/Care Coordinator
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	3747P1801X	Personal Care Attendant
5	106H00000X	Marriage & Family Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962717959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SHAW-WILSON

Provider Business Mailing Address
First Line	:	3599 UNIVERSITY BLVD S STE 1200
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4288
Country	:	US
Telephone Number	:	904-712-3540
Fax Number	:	904-775-3570

Provider Business Practice Location Address
First Line	:	3599 UNIVERSITY BLVD S STE 1200
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4288
Country	:	US
Telephone Number	:	904-712-3540
Fax Number	:	904-775-3570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	02/07/2026

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Directions to “ RACHEL SHAW-WILSON ” Practice Location

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