Active NPI
Ryan R Shrode, ARNP
- Family Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1194070862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP9186197
- Practice address
- 836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344 - Phone
- (904) 398-0125
- Fax
- (904) 398-1832
- NPI assigned
- Jul 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 9186197 | FL | |
| Family Nurse Practitioner | 363LF0000X | ARNP9186197 | FL | Primary |
Addresses
Primary practice location
836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344
Mailing address
PO Box 43667
Jacksonville, FL 32203-3667
Phone (904) 720-0599
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9186197 | FL | MD | Licensed Practical Nurse |
| ARNP9186197 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Cardiology, Inc. | Family | Current | Accepting new patients |
Locations
836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125
1361 13th Ave S
Ste 270
Jacksonville Beach, FL 32250
Phone (904) 241-7147
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": "1342656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540512000000",
"number": "1194070862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43667",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322033667",
"telephone_number": "904-720-0599",
"fax_number": "904-376-4036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 PRUDENTIAL DR STE 1700",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078344",
"telephone_number": "904-398-0125",
"fax_number": "904-398-1832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRODE",
"first_name": "RYAN",
"middle_name": "R",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-19",
"last_updated": "2018-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "9186197",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP9186197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.