Donna Shepherd Ennis, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 9200638 Issued in FL

Practice address

21 W Main Ave
Defuniak Springs, FL 32435-2529

Phone

(850) 892-7332

Fax

(850) 892-2405

NPI assigned

Jun 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charlottesville Wellness Center Family Practice

  • Family Medicine Physician
  • Charlottesville, VA
  • NPI 1013954544
  NPD (past)
• Long-Term Care Physicians of Alabama Inc

  dba Long-Term Care Physicians, Inc

  • Skilled Nursing Facility
  • Cullman, AL
  • NPI 1194819375
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164625208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 FURLING LN",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415331",
            "telephone_number": "850-974-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W MAIN AVE",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324352529",
            "telephone_number": "850-892-7332",
            "fax_number": "850-892-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "DONNA",
        "middle_name": "SHEPHERD",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9200638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsa Veronica Dunaway
• Sharla Mechele Durden, CCC-SLP
• Candice Jade Earnest, RBT
• Emerald Coast Medical Services Inc
• Emerald Springs Family Counseling LLC
• Joe R. Evans III, O.D.
• Fawaz Medical and Surgical Clinic, LLC
• Fawzi Fawaz, M. D.
• Patricia A Ferman, MS, RD, LD
• Maria Loreto Fernandez Puig

• Family Nurse Practitioner in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.