Active NPI
Shannon Rae Hurst, LPN
- Geriatric Psychiatry Physician
- Neptune Beach, FL
National Provider Identifier
1104755974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- PN1346211
- Practice address
- 1100 Seagate Ave Apt 258
Neptune Beach, FL 32266-3521 - Phone
- (904) 898-0263
- NPI assigned
- May 18, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | PN1346211 | FL | Primary |
Addresses
Primary practice location
1100 Seagate Ave Apt 258
Neptune Beach, FL 32266-3521
Mailing address
1100 Seagate Ave Apt 258
Neptune Beach, FL 32266-3521
Phone (904) 898-0263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN1346211 | FL | MD | Geriatric Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779062400000",
"number": "1104755974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SEAGATE AVE APT 258",
"city": "NEPTUNE BEACH",
"state": "FL",
"postal_code": "322663521",
"telephone_number": "904-898-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SEAGATE AVE APT 258",
"city": "NEPTUNE BEACH",
"state": "FL",
"postal_code": "322663521",
"telephone_number": "904-898-0263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURST",
"first_name": "SHANNON",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-05-18",
"last_updated": "2026-05-18",
"certification_date": "2026-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "FL",
"license": "PN1346211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neptune Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.