Individual provider Active NPI

Michele Shockley, ARNP

  • Women's Health Nurse Practitioner
  • Jupiter, FL
National Provider Identifier
1023069952
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
ARNP2754972 Issued in FL
Practice address
136 Jupiter Lakes Blvd
Building 2000
Jupiter, FL 33458-7180
Phone
(561) 748-1888
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X ARNP2754972 FL Primary

Addresses

Primary practice location

136 Jupiter Lakes Blvd
Building 2000
Jupiter, FL 33458-7180

Mailing address

136 Jupiter Lakes Blvd
Building 2000
Jupiter, FL 33458-7180
Phone (561) 748-1888

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
I20100924000925 FL Practitioner - Nurse Practitioner 0143346346 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2754972FLMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriella Bonomo, MD, PA CurrentSince Aug 31, 2021 Accepting new patients
Healthy Women P.a. Past Accepting new patients

Locations

500 University Blvd
Ste 201
Jupiter, FL 33458
Phone (561) 662-5490

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1023069952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JUPITER LAKES BLVD",
            "address_2": "BUILDING 2000",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587180",
            "telephone_number": "561-748-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 JUPITER LAKES BLVD",
            "address_2": "BUILDING 2000",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587180",
            "telephone_number": "561-748-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "MICHELE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "ARNP2754972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.