Individual provider Active NPI

Sheila Casabar

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1356889232
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
APRN9208715 Issued in FL
Practice address
5011 Gate Parkway
BLDG 100 Ste 100
Jacksonville, FL 32256-3225
Phone
(904) 512-7239
Fax
(866) 380-0827
NPI assigned
Feb 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X APRN9208715 FL
Nurse Practitioner 363L00000X APRN9208715 FL
Registered Nurse 163W00000X RN9208715 FL
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X APRN9208715 FL Primary

Addresses

Primary practice location

5011 Gate Parkway
BLDG 100 Ste 100
Jacksonville, FL 32256-3225

Mailing address

5011 Gate Pkwy Ste 100 BLDG 100
Jacksonville, FL 32256-0830
Phone (904) 512-7239

Other practice location 1

3615 University Blvd S
Jacksonville, FL 32216
Phone (904) 702-6920

Other identifiers 1

IdentifierTypeStateIssuer
202248493MedicaidFL

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
I20170524000046 FL Practitioner - Nurse Practitioner 9436426475 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9208715FLMDRegistered Nurse
APRN9208715FLMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC Multi-Specialty CurrentSince Dec 14, 2019 Accepting new patients
KND Development 59 LLC Multi-Specialty Current Accepting new patients
Aaron J West MD PA Multi-Specialty CurrentSince Jan 1, 2019 Accepting new patients
Symphony Specialty Group, LLC Multi-Specialty PastSince Jul 17, 2023 Accepting new patients

Locations

801 Oak St
Green Cv Spgs, FL 32043
Phone (904) 215-7015

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

5011 Gate Pkwy
Bldg 100
Jacksonville, FL 32256
Phone (904) 512-7239

8773 Perimeter Park Ct
Jacksonville, FL 32216
Phone (904) 493-3390

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

Organizations & group practices 4

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": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1356889232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 GATE PKWY STE 100 BLDG 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560830",
            "telephone_number": "904-512-7239",
            "fax_number": "866-380-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 GATE PARKWAY",
            "address_2": "BLDG 100 STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563225",
            "telephone_number": "904-512-7239",
            "fax_number": "866-380-0827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3615 University Blvd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32216",
            "country_code": "US",
            "telephone_number": "904-702-6920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASABAR",
        "first_name": "SHEILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "APRN9208715",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9208715",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9208715",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "APRN9208715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202248493",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.