Scott Alan Shirley, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN11021337 Issued in FL

Practice address

2349 Village Square Pkwy Ste 112
Fleming Island, FL 32003-4319

Phone

(904) 886-9686

Fax

(904) 253-6964

NPI assigned

Aug 12, 2022

Sex

Male

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Lung Clinic LLCGroup PAC ID 4486900412, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Jacksonville Lung Clinic LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Jacksonville Beach, FL
  • NPI 1861991937
  Medicare reassignment Care Compare group NPD
• Cancer Specialists, LLC

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1528323268
  Medicare reassignment NPD
• Respiratory Critical Care and Sleep Medicine Associates,Inc

  • Pulmonary Disease Physician
  • Jacksonville, FL
  • NPI 1386622629
  Medicare reassignment NPD
• Cancer Specialists, LLC

  • Pharmacy
  • Jacksonville, FL
  • NPI 1851656607
  NPD

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

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1104554526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10922 SCOTT MILL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236512",
            "telephone_number": "904-508-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 VILLAGE SQUARE PKWY STE 112",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034319",
            "telephone_number": "904-886-9686",
            "fax_number": "904-253-6964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 Baptist Clay Dr",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320038502",
            "country_code": "US",
            "telephone_number": "904-253-6910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 3rd St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Neptune Beach",
            "state": "FL",
            "postal_code": "322665082",
            "country_code": "US",
            "telephone_number": "904-997-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-12",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11021337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Satish P Shanbhag, MD,MPH
• Emily Shaw
• Mya R Shaw
• Riley Alexander Shaw
• Angela Marie Shih, APRN
• Jennifer Marie Sidey, MD
• Calvin Siegers, MD
• Hobie J Simmons
• Kayla Elizabeth Simmons
• Kimberly Simon, APRN

• Acute Care Nurse Practitioner in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.