Individual provider Active NPI

Shauna Lynn Sandford, NP

  • Women's Health Clinical Nurse Specialist
  • Palm Coast, FL
National Provider Identifier
1104372564
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Clinical Nurse SpecialistTaxonomy code 364SW0102X
License
APRN11010920 Issued in FL
Practice address
50 Cypress Point Pkwy Ste B1
Palm Coast, FL 32164-2501
Phone
(386) 283-4180
NPI assigned
Aug 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APN.099058-NP CO
Women's Health Clinical Nurse Specialist 364SW0102X APRN11010920 FL Primary
Registered Nurse 163W00000X RN.0205262 CO

Addresses

Primary practice location

50 Cypress Point Pkwy Ste B1
Palm Coast, FL 32164-2501

Mailing address

685 Natureland Cir
Saint Augustine, FL 32092-3309
Phone (303) 667-5019

Other practice location 1

7720 S Broadway Ste 440
Littleton, CO 80122-2624
Phone (303) 795-0890

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
I20220708000495 FL Practitioner - Nurse Practitioner 6608256698 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.0205262COMDRegistered Nurse
APN.099058-NPCOMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC CurrentSince Jul 5, 2022 Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

1301 Plantation Island Dr S
Ste 103
Saint Augustine, FL 32080
Phone (904) 461-5330

Organizations & group practices 1

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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1104372564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 NATURELAND CIR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923309",
            "telephone_number": "303-667-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CYPRESS POINT PKWY STE B1",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642501",
            "telephone_number": "386-283-4180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7720 S Broadway Ste 440",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801222624",
            "country_code": "US",
            "telephone_number": "303-795-0890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDFORD",
        "first_name": "SHAUNA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "APN.099058-NP",
            "primary": false
        },
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "FL",
            "license": "APRN11010920",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0205262",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.