Individual provider Active NPI

Shavondra Huggins, WHNP-BC, FNP-C

  • Women's Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1124263256
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
ARNP9198927 Issued in FL
Practice address
9560 Crosshill Blvd
Suite 110
Jacksonville, FL 32222-5827
Phone
(904) 308-7792
Fax
(904) 779-7335
NPI assigned
Dec 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X ARNP9198927 FL Primary

Addresses

Primary practice location

9560 Crosshill Blvd
Suite 110
Jacksonville, FL 32222-5827

Mailing address

9560 Crosshill Blvd
Suite 110
Jacksonville, FL 32222-5827
Phone (904) 308-7792

Other identifiers 2

IdentifierTypeStateIssuer
003108960AMedicaidGA
0035385-00MedicaidFL

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
I20110608000748 FL Practitioner - Nurse Practitioner 2264619790 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9198927FLMDWomen's Health Nurse Practitioner

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": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1124263256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9560 CROSSHILL BLVD",
            "address_2": "SUITE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225827",
            "telephone_number": "904-308-7792",
            "fax_number": "904-779-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9560 CROSSHILL BLVD",
            "address_2": "SUITE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225827",
            "telephone_number": "904-308-7792",
            "fax_number": "904-779-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGGINS",
        "first_name": "SHAVONDRA",
        "name_prefix": "Ms.",
        "credential": "WHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "ARNP9198927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108960A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035385-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.