Individual provider Active NPI

Shunta Tanesheva Jackson-Smith, APRN

  • Family Nurse Practitioner
  • Boynton Beach, FL
National Provider Identifier
1306128533
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9196308 Issued in FL
Practice address
2923 S Federal Hwy Ste 100
Boynton Beach, FL 33435-7751
Phone
(561) 752-0100
Fax
(561) 740-3001
NPI assigned
Sep 14, 2011
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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 APRN9196308 FL Primary

Addresses

Primary practice location

2923 S Federal Hwy Ste 100
Boynton Beach, FL 33435-7751

Mailing address

2923 S Federal Hwy Ste 100
Boynton Beach, FL 33435-7751
Phone (561) 752-0100

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
I20120510000159 FL Practitioner - Nurse Practitioner 4486816329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daniel Heart and Vascular Center PAGroup PAC ID 5496802233, 4 clinicians

Practice addresses (Care Compare)

2923 S Federal Hwy
Suite 100
Boynton Beach, FL 33435-7745
Phone (561) 752-0100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9196308FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Heart & Vascular Center PA CurrentSince Dec 4, 2025 Accepting new patients
Jupiter Hospitalists Inc CurrentSince Jan 1, 2012 Accepting new patients

Locations

2923 S Federal Hwy
Ste 100
Boynton Beach, FL 33435
Phone (561) 740-0100

5352 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-3166

210 Jupiter Lakes Blvd
Ste 4202
Jupiter, FL 33458
Phone (561) 366-6777

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

Organizations & group practices 2

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 1

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": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1306128533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 S FEDERAL HWY STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357751",
            "telephone_number": "561-752-0100",
            "fax_number": "561-740-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 S FEDERAL HWY STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357751",
            "telephone_number": "561-752-0100",
            "fax_number": "561-740-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-SMITH",
        "first_name": "SHUNTA",
        "middle_name": "TANESHEVA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9196308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.