Individual provider Active NPI

Shawn Nixon, APRN

  • Primary Care Nurse Practitioner
  • Windermere, FL
National Provider Identifier
1053949941
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11023852 Issued in FL
Practice address
5151 Winter Garden Vineland Rd Ste 208
Windermere, FL 34786-6098
Phone
(407) 636-7802
NPI assigned
Mar 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.026573 OH
Primary Care Nurse Practitioner 363LP2300X APRN11023852 FL Primary

Addresses

Primary practice location

5151 Winter Garden Vineland Rd Ste 208
Windermere, FL 34786-6098

Mailing address

5151 Winter Garden Vineland Rd
Windermere, FL 34786-6098
Phone (407) 636-7802

Other practice location 1

5151 Winter Garden Vineland Rd Ste 208
Windermere, FL 34786-6098
Phone (407) 636-7802

Other practice location 2

7243 Della Dr
SteK
Orlando, FL 32819-5106
Phone (407) 381-7366

Other practice location 3

800 N Maitland Ave Ste 103
Maitland, FL 32751-4499
Phone (407) 660-7100

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
I20230825001508 FL Practitioner - Nurse Practitioner 0547683120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

5151 Winter Garden Vineland Rd
Suite 208
Windermere, FL 34786-6098
Phone (407) 614-8320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.026573OHMDFamily Nurse Practitioner
APRN11023852FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc CurrentSince Jul 1, 2023 Accepting new patients
Physician Associates LLC Past Accepting new patients

Locations

800 N Maitland Ave
Maitland, FL 32751
Phone (407) 660-7100

800 N Maitland Ave
Ste 103
Maitland, FL 32751
Phone (407) 660-7011

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

7243 Della Dr
Ste K
Orlando, FL 32819
Phone (407) 370-8705

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Interoperability endpoints

  • Direct secure messaging: shawn.nixon@cccl.eclinicaldirectplus.com

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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1053949941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 WINTER GARDEN VINELAND RD",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866098",
            "telephone_number": "407-636-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 WINTER GARDEN VINELAND RD STE 208",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866098",
            "telephone_number": "407-636-7802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5151 Winter Garden Vineland Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Windermere",
            "state": "FL",
            "postal_code": "347866098",
            "country_code": "US",
            "telephone_number": "407-636-7802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7243 Della Dr",
            "address_2": "SteK",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328195106",
            "country_code": "US",
            "telephone_number": "407-381-7366",
            "fax_number": "321-203-4625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 N Maitland Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327514499",
            "country_code": "US",
            "telephone_number": "407-660-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIXON",
        "first_name": "SHAWN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026573",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11023852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

Verify at the official NPI Registry.