Individual provider Active NPI

Shana Lee Vongkhankeo, APRN, FNP-C

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1073144994
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11005527 Issued in FL
Practice address
250 N Alafaya TRL Ste 100
Orlando, FL 32828-4316
Phone
(407) 282-4400
NPI assigned
Jan 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11005527 FL Primary

Addresses

Primary practice location

250 N Alafaya TRL Ste 100
Orlando, FL 32828-4316

Mailing address

250 N Alafaya TRL Ste 100
Orlando, FL 32828-4316
Phone (407) 282-4400

Other identifiers 1

IdentifierTypeStateIssuer
105858200MedicaidFL

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
I20200405000006 FL Practitioner - Nurse Practitioner 1355770868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11005527FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Sep 13, 2021 Accepting new patients
Adventhealth Primary Care Network Inc Family CurrentSince Nov 1, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 13, 2021 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

755 Rinehart Rd
Ste 200
Lake Mary, FL 32746
Phone (407) 320-8100

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

250 N Alafaya Trl
Ste 100
Orlando, FL 32828
Phone (407) 282-4400

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

Interoperability endpoints

  • Direct secure messaging: svongkhankeo73696@adventhealth.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1073144994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N ALAFAYA TRL STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284316",
            "telephone_number": "407-282-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N ALAFAYA TRL STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284316",
            "telephone_number": "407-282-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGKHANKEO",
        "first_name": "SHANA",
        "middle_name": "LEE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105858200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.