Individual provider Active NPI

Shayne Nicole Moyles, D.O

  • Internal Medicine Physician
  • Parrish, FL
National Provider Identifier
1407032030
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS9968 Issued in FL
Practice address
12271 US Highway 301 N
Parrish, FL 34219-8410
Phone
(941) 776-4050
Fax
(941) 776-4057
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS9968 FL Primary

Addresses

Primary practice location

12271 US Highway 301 N
Parrish, FL 34219-8410

Mailing address

700 8TH Ave W Ste 101
Palmetto, FL 34221-4737
Phone (941) 776-4000

Other identifiers 2

IdentifierTypeStateIssuer
BH963VOtherFLMEDICARE PTAN
000877600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090211000383 FL Practitioner - Internal Medicine 7214092022 Reassigns benefits to 5 organizations
I20170530002306 ME Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 7214092022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCR Health IncGroup PAC ID 7214847995, 132 clinicians

Practice addresses (Care Compare)

12271 US Hwy 301 N
Parrish, FL 34219-8410
Phone (941) 713-2231

206 2ND St E
Bradenton, FL 34208-1042
Phone (941) 746-5111

Hospital & facility affiliations

  • Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Calais Community Hospital CurrentSince May 15, 2017 Accepting new patients
St. Francis Pathways to Healthcare, LLC CurrentSince Feb 19, 2022 Accepting new patients
Pensacola Hospitalist Physicians, LLC CurrentSince Jan 15, 2021 Accepting new patients
Floridian Hospitalist Services, LLC Current Accepting new patients
MCR Health, Inc. CurrentSince Jan 4, 2019 Accepting new patients
Pensacola Hospitalist Physicians, LLC CurrentSince Jan 15, 2021 Accepting new patients
Calais Community Hospital CurrentSince May 15, 2017 Accepting new patients
MCR Health, Inc. CurrentSince Jan 4, 2019 Accepting new patients
Gulfside Hospice, Inc. Past Accepting new patients
Floridian Emergency Specialists, LLC PastSince Jan 26, 2020 Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

250 N Wickham Rd
Melbourne, FL 32935
Phone (321) 637-2600

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

1250 Grumman Pl
Ste B
Titusville, FL 32780
Phone (321) 269-4240

24 Hospital Ln
Calais, ME 04619
Phone (207) 454-9213

Interoperability endpoints

  • Direct secure messaging: shayne.moyles.1@11352.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 11

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.

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": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1407032030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12271 US HIGHWAY 301 N",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342198410",
            "telephone_number": "941-776-4050",
            "fax_number": "941-776-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLES",
        "first_name": "SHAYNE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS9968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BH963V",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000877600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parrish, FL

Sources for this page

Verify at the official NPI Registry.