Individual provider Active NPI

Shara Lanecia McPhall, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1003542549
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11020143 Issued in FL
Practice address
1542 Kingsley Ave Ste 136
Orange Park, FL 32073-4547
Phone
(239) 223-2751
NPI assigned
Jul 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11020143 FL Primary

Addresses

Primary practice location

1542 Kingsley Ave Ste 136
Orange Park, FL 32073-4547

Mailing address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (239) 236-8784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231004001560 FL Practitioner - Nurse Practitioner 9133573520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

1542 Kingsley Ave
Suite 136
Orange Park, FL 32073-4547
Phone (239) 223-2751

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11020143FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Dna Comprehensive Therapy Services, LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

1542 Kingsley Ave
Ste 136
Orange Park, FL 32073
Phone (904) 214-3222

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: shara.mcphall.1@13142.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/13142/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1003542549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-236-8784",
            "fax_number": "239-790-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE STE 136",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734547",
            "telephone_number": "239-223-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHALL",
        "first_name": "SHARA",
        "middle_name": "LANECIA",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11020143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.