Individual provider Active NPI

Veronica Shahan, APRN

  • Nurse Practitioner
  • Middleburg, FL
National Provider Identifier
1003664202
Registry record updated May 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11032689 Issued in FL
Practice address
1861 Penzance Pkwy
Middleburg, FL 32068-3934
Phone
(706) 248-3433
NPI assigned
May 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11032689 FL Primary

Addresses

Primary practice location

1861 Penzance Pkwy
Middleburg, FL 32068-3934

Mailing address

1861 Penzance Pkwy
Middleburg, FL 32068-3934
Phone (706) 248-3433

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
I20240604002264 FL Practitioner - Nurse Practitioner 3274075445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease ConsultantsGroup PAC ID 1850515040, 18 clinicians

Practice addresses (Care Compare)

2151 Riverside Ave
Jacksonville, FL 32204-4416
Phone (904) 388-8686

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11032689FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Consultants Nurse Practitioner CurrentSince May 21, 2024 Accepting new patients

Locations

2151 Riverside Ave
Jacksonville, FL 32204
Phone (904) 381-8900

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1003664202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 PENZANCE PKWY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683934",
            "telephone_number": "706-248-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 PENZANCE PKWY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683934",
            "telephone_number": "706-248-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAN",
        "first_name": "VERONICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11032689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.