Active NPI
Shannon Large, ARNP, DNP
- Adult Health Nurse Practitioner
- Gainesville, FL
National Provider Identifier
1356645352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- ARNP9264277
- Practice address
- 4001 SW 13TH Street
Florida Recovery Center
Gainesville, FL 32608 - Phone
- (352) 265-5534
- NPI assigned
- Jan 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP9264277 | FL | Primary |
Addresses
Primary practice location
4001 SW 13TH Street
Florida Recovery Center
Gainesville, FL 32608
Mailing address
4001 SW 13TH Street
Florida Recovery Center
Gainesville, FL 32608
Phone (352) 265-5534
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009198200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1356645352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 SW 13TH STREET",
"address_2": "FLORIDA RECOVERY CENTER",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32608",
"telephone_number": "352-265-5534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 SW 13TH STREET",
"address_2": "FLORIDA RECOVERY CENTER",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32608",
"telephone_number": "352-265-5534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARGE",
"first_name": "SHANNON",
"name_prefix": "Mrs.",
"credential": "ARNP, DNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-05",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "ARNP9264277",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009198200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.