Individual provider Active NPI

Shanna Ann Sherman, ARNP

  • Pediatric Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1013253590
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9258728 Issued in FL
Practice address
601 5TH St S
Suite 605
St Petersburg, FL 33701-4804
Phone
(727) 822-4300
Fax
(727) 456-1399
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9258728 FL Primary

Addresses

Primary practice location

601 5TH St S
Suite 605
St Petersburg, FL 33701-4804

Mailing address

2901 58TH Ave N
St Petersburg, FL 33714-1326
Phone (727) 822-4300

Other identifiers 1

IdentifierTypeStateIssuer
007950100MedicaidFL

Other names 1

  • Ms. Shanna Ann Cobb Former name

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
I20140206001705 FL Practitioner - Nurse Practitioner 2466681713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Gastroenterology Hepatology & Nutrition of FL P a CurrentSince Jan 5, 2014 Accepting new patients

Locations

9400 Gladiolus Dr
Ste 100
Fort Myers, FL 33908
Phone (239) 223-0484

5640 Main St
New Pt Richey, FL 34652
Phone (727) 822-4300

2901 58th Ave N
St Petersburg, FL 33714

601 5th St S
Ste 605
St Petersburg, FL 33701
Phone (727) 822-4300

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.

NPI Registry JSON

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1013253590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 58TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337141326",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "SUITE 605",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "SHANNA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9258728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007950100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNA",
            "last_name": "COBB",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.