Individual provider Active NPI

Shante Houston

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1124819347
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11039250 Issued in FL
Practice address
2014 Edgewater Dr PMB 270
Orlando, FL 32804-5312
Phone
(689) 322-9753
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11039250 FL Primary

Addresses

Primary practice location

2014 Edgewater Dr PMB 270
Orlando, FL 32804-5312

Mailing address

2014 Edgewater Dr PMB 270
Orlando, FL 32804-5312

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
I20250724004408 FL Practitioner - Nurse Practitioner 5698282689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern NP Associates LLCGroup PAC ID 1557686243, 52 clinicians

Practice addresses (Care Compare)

1055 3Rd St
Daytona Beach, FL 32117-4101
Phone (205) 343-7300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11039250FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tricounty Physicians, LLC CurrentSince Jul 7, 2025 Accepting new patients
Southern NP Associates, LLC CurrentSince Jan 19, 2026 Accepting new patients
Villa Health Pulmonary LLC CurrentSince Jul 8, 2026 Accepting new patients

Locations

1055 3rd St
Holly Hill, FL 32117
Phone (386) 252-3686

1507 Buenos Aires Blvd
The Villages, FL 32159
Phone (352) 350-1600

4068 E State Road 44
Wildwood, FL 34785
Phone (352) 564-3655

Organizations & group practices 3

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": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1124819347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 EDGEWATER DR PMB 270",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 EDGEWATER DR PMB 270",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045312",
            "telephone_number": "689-322-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "SHANTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11039250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.