Individual provider Active NPI

Shannon Louise Schaal, APRN PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1013534205
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11010424 Issued in FL
Practice address
3974 SW Wycoff St
Port Saint Lucie, FL 34953-5314
Phone
(772) 201-4188
NPI assigned
Jul 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11010424 FL Primary
Registered Nurse 163W00000X RN9352788 FL

Addresses

Primary practice location

3974 SW Wycoff St
Port Saint Lucie, FL 34953-5314

Mailing address

3974 SW Wycoff St
Port Saint Lucie, FL 34953-5314
Phone (772) 201-4188

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
I20211130002061 FL Practitioner - Nurse Practitioner 6800286196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

7999 N Federal Hwy
Suite 202
Boca Raton, FL 33487-1673
Phone (561) 285-3503

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9352788FLMDRegistered Nurse
APRN11010424FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Treatment Centers of America, LLC CurrentSince Jul 2, 2024 Accepting new patients
Thriveworks Clinical - Florida Inc CurrentSince Jun 9, 2022 Accepting new patients
Treatment Centers of America, LLC CurrentSince Jul 2, 2024 Accepting new patients

Locations

7999 N Federal Hwy
Ste 202
Boca Raton, FL 33487
Phone (561) 285-3503

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

1405 SE Goldtree Dr
Ste Ab
Port St Lucie, FL 34952
Phone (855) 700-0327

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 3

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": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1013534205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3974 SW WYCOFF ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535314",
            "telephone_number": "772-201-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3974 SW WYCOFF ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535314",
            "telephone_number": "772-201-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAAL",
        "first_name": "SHANNON",
        "middle_name": "LOUISE",
        "credential": "APRN PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-03",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11010424",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9352788",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.