Individual provider Active NPI

Shannon Renee Parkinson, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1417530585
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011752 Issued in FL
Practice address
751 SE Sycamore Ter
Lake City, FL 32025-6216
Phone
(386) 758-0600
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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 APRN11011752 FL Primary

Addresses

Primary practice location

751 SE Sycamore Ter
Lake City, FL 32025-6216

Mailing address

21352 NE 65TH St
Williston, FL 32696-5707
Phone (352) 361-8229

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)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
APRN11011752FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1417530585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21352 NE 65TH ST",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326965707",
            "telephone_number": "352-361-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 SE SYCAMORE TER",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256216",
            "telephone_number": "386-758-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKINSON",
        "first_name": "SHANNON",
        "middle_name": "RENEE",
        "name_prefix": "Miss",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.