Individual provider Active NPI

Shannon Nichole Groleau, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1023254299
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9207713 Issued in FL
Practice address
3100 University Blvd S Ste 300
Jacksonville, FL 32216-2752
Phone
(904) 274-8813
Fax
(904) 503-4465
NPI assigned
Dec 18, 2008
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chronic Care Clinical Nurse Specialist 364SC2300X APRN9207713 FL
Medical-Surgical Clinical Nurse Specialist 364SM0705X ARNP9207713 FL
Adult Health Nurse Practitioner 363LA2200X ARNP9207713 FL
Nurse Practitioner 363L00000X APRN9207713 FL Primary

Addresses

Primary practice location

3100 University Blvd S Ste 300
Jacksonville, FL 32216-2752

Mailing address

3100 University Blvd S Ste 300
Jacksonville, FL 32216-2752
Phone (904) 274-8813

Other practice location 1

15255 Max Leggett Pkwy Ste 5500
Jacksonville, FL 32218-7283
Phone (904) 223-3321

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
I20130830000216 FL Practitioner - Nurse Practitioner 8628211257

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGEICD/Endpoint/EGEICD
  • Direct secure messaging: shannon.groleau@22525903.chartlogic.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1023254299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 UNIVERSITY BLVD S STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162752",
            "telephone_number": "904-274-8813",
            "fax_number": "904-503-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 UNIVERSITY BLVD S STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162752",
            "telephone_number": "904-274-8813",
            "fax_number": "904-503-4465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15255 Max Leggett Pkwy Ste 5500",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187283",
            "country_code": "US",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROLEAU",
        "first_name": "SHANNON",
        "middle_name": "NICHOLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC2300X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Chronic Care",
            "state": "FL",
            "license": "APRN9207713",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "FL",
            "license": "ARNP9207713",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9207713",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9207713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.