Individual provider Active NPI

Shawn Stephens

  • Gerontology Nurse Practitioner
  • Saint Cloud, FL
National Provider Identifier
1104651603
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11035070 Issued in FL
Practice address
2906 17TH St
Saint Cloud, FL 34769-6006
Phone
(407) 892-2135
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11035070 FL
Gerontology Nurse Practitioner 363LG0600X 11035070 FL Primary

Addresses

Primary practice location

2906 17TH St
Saint Cloud, FL 34769-6006

Mailing address

5516 Great Egret Dr
Leesburg, FL 34748-2034
Phone (813) 503-1702

Other practice location 1

525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone (407) 647-2346

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
I20241213000647 FL Practitioner - Nurse Practitioner 8426584467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Solutions Medical Specialists LLCGroup PAC ID 7517491160, 11 clinicians

Practice addresses (Care Compare)

525 Technology Park
Suite 109
Lake Mary, FL 32746-7107
Phone 4076472346111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11035070FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Healthcare PA CurrentSince Oct 23, 2024 Accepting new patients
Solutions Medical Specialists LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

1805 SE Lake Weir Ave
Ste B
Ocala, FL 34471
Phone (352) 629-9634

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1104651603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 GREAT EGRET DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347482034",
            "telephone_number": "813-503-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696006",
            "telephone_number": "407-892-2135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Technology Park Ste 109",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327467107",
            "country_code": "US",
            "telephone_number": "407-647-2346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11035070",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11035070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.