Individual provider Active NPI

Jennifer Blanche Shue, APRN

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1184212193
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010737 Issued in FL
Practice address
15 W Maxwell St
Ste 148
Pensacola, FL 32501-1717
Phone
(850) 434-0077
Fax
(850) 434-0220
NPI assigned
Jan 5, 2021
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11010737 FL Primary

Addresses

Primary practice location

15 W Maxwell St
Ste 148
Pensacola, FL 32501-1717

Mailing address

15 W Maxwell St
Ste 148
Pensacola, FL 32501
Phone (850) 434-0077

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Admin@Southernpractitioner.com Direct

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
I20210126000345 FL Practitioner - Nurse Practitioner 4082028543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key West Hma Physician Management LLCGroup PAC ID 0749178408, 33 clinicians

Practice addresses (Care Compare)

1111 12TH St
Key West, FL 33040-4084

1111 12TH St
Suite 203
Key West, FL 33040-3000
Phone (305) 294-1706

3224 N Roosevelt Blvd
Key West, FL 33040-4114
Phone (305) 292-5877

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010737FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Key West Hma Physician Management LLC CurrentSince Jul 11, 2022 Accepting new patients
Key West Hma Physician Management, LLC CurrentSince Jul 11, 2022 Accepting new patients
The Southern Practitioner Group Family PastSince Nov 7, 2025 Accepting new patients

Locations

3224 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 292-5877

1111 12th St
Ste 104
Key West, FL 33040
Phone (305) 293-1830

Interoperability endpoints

  • Direct secure messaging: jennifer.shue.1@4692.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1184212193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W MAXWELL ST",
            "address_2": "STE 148",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32501",
            "telephone_number": "850-434-0077",
            "fax_number": "850-434-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W MAXWELL ST",
            "address_2": "STE 148",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011717",
            "telephone_number": "850-434-0077",
            "fax_number": "850-434-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUE",
        "first_name": "JENNIFER",
        "middle_name": "BLANCHE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-03-02",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Admin@Southernpractitioner.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15 W Maxwell St",
            "address_2": "Ste 148",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325011717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.