Shannon Boston, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11004710 Issued in FL

Practice address

19225 US Highway 27
Clermont, FL 34715-9025

Phone

(352) 394-6146

NPI assigned

Dec 21, 2019

Last updated

Dec 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1033758081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 PATACHES PL",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347368047",
            "telephone_number": "305-834-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19225 US HIGHWAY 27",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347159025",
            "telephone_number": "352-394-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-21",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11004710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Clermont, FL
• Providers in Clermont, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.