Stanvonna Shootes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

435 Clark Rd
Suite 107
Jacksonville, FL 32218-5596

Phone

(904) 765-0665

Fax

(904) 765-0664

NPI assigned

Aug 5, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Right Path Behavioral Health Services, LLC.

  • Community/Behavioral Health Agency
  • Ft Lauderdale, FL
  • NPI 1255139838
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1003225970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 SUNSET DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322084637",
            "telephone_number": "904-485-0715",
            "fax_number": "904-765-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 CLARK RD",
            "address_2": "SUITE 107",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185596",
            "telephone_number": "904-765-0665",
            "fax_number": "904-765-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOTES",
        "first_name": "STANVONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Shoemaker, PA-C
• Mary Lynnette Shoffner
• Roseline Oghomwen Shofolu
• Payal Paresh Patel Shooliz, MD
• Pouya Shooliz, M.D.
• Remington Shopa
• Shopjveon LLC
• Shore Labs LLC
• James David Shore, D.C.
• Carol Getker Shores, MD

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.