Individual provider Active NPI

Shawnette Miles, MSW

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1194380006
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13528 Issued in FL
Practice address
112 W Cervantes St
Pensacola, FL 32501-3128
Phone
(850) 361-8967
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13528 FL Primary

Addresses

Primary practice location

112 W Cervantes St
Pensacola, FL 32501-3128

Mailing address

2355 W Michigan Ave Apt E10
Pensacola, FL 32526-2326
Phone (850) 361-8967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250915002393 TX Practitioner - Clinical Social Worker 4688196009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2111 Old Holzwarth Rd
Apt 1206
Spring, TX 77388-4691

9015 Snapping Turtle Dr
Humble, TX 77338-1527

PO Box
Suite 60976
Houston, TX 77205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13528FLMDClinical Social Worker
114699TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCS, PC Clinical CurrentSince Feb 10, 2025 Accepting new patients
Sound Decisions LLC Clinical CurrentSince Jul 1, 2025 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

1801 NE 123rd St
Ste 314
North Miami, FL 33181
Phone (239) 380-8220

8040 Georgia Ave
Ste 170
Silver Spring, MD 20910
Phone (301) 284-0207

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": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1194380006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 W MICHIGAN AVE APT E10",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325262326",
            "telephone_number": "850-361-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W CERVANTES ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013128",
            "telephone_number": "850-361-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "SHAWNETTE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "13528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.