Shannon Denise Shea, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME130808 Issued in FL

Practice address

3900 University Blvd S Ste 2
Jacksonville, FL 32216-4331

Phone

(904) 760-4940

NPI assigned

Apr 23, 2010

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  Pediatrics

  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Developmental - Behavioral Pediatrics Physician
  • Jacksonville, FL
  • NPI 1649430919
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1053638551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KING ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042410",
            "telephone_number": "904-760-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 UNIVERSITY BLVD S STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164331",
            "telephone_number": "904-760-4940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5460 Blanding Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322441957",
            "country_code": "US",
            "telephone_number": "904-760-4904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1880 Edgewood Ave W",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322083021",
            "country_code": "US",
            "telephone_number": "904-760-4904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6024 Merrill Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322773427",
            "country_code": "US",
            "telephone_number": "904-760-4904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1680 Dunn Ave Ste 35",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322184744",
            "country_code": "US",
            "telephone_number": "904-760-4904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 King St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322042410",
            "country_code": "US",
            "telephone_number": "904-760-4904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEA",
        "first_name": "SHANNON",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME130808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Shaykh, DO
• Adam A Shbeb, DDS
• SHC Home Health Services - Jacksonville, LLC
• Jonathan Grant Shea, PHARMD
• Kelly Maureen Shea, RCPH
• Sarah Jane Sheahan
• Kendra D Shealey
• Sheanas Care Support LLC
• Amanda Lauramore Shearer, M.D.
• Jeffrey D Shearer, OD

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.