Active NPI
John Devin Shorey, LMHC, RMFTI
- Mental Health Counselor
- Trenton, FL
National Provider Identifier
1417566464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 19625
- Practice address
- 728 NE 7TH St
Trenton, FL 32693-3637 - Phone
- (352) 374-5600
- NPI assigned
- Jul 27, 2020
- Last updated
- Aug 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 19625 | FL | Primary |
| Marriage & Family Therapist | 106H00000X | 3069 | FL |
Addresses
Primary practice location
728 NE 7TH St
Trenton, FL 32693-3637
Mailing address
1001 NE 16TH Ave
Gainesville, FL 32601-2511
Phone (352) 448-9120
Other practice location 1
1001 NE 16th Ave
Gainesville, FL 32601-2511
Phone (352) 448-9120
Other practice location 2
103 NE 1st St
Chiefland, FL 32626-0920
Phone (352) 374-5600 ext. 8860
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19625 | FL | MD | Mental Health Counselor |
| 3069 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gainesville Community Counseling Center | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community Health Clinic/Center
- Gainesville, FL
- NPI 1710470851
Marriage & Family Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1417566464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 NE 16TH AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326012511",
"telephone_number": "352-448-9120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "728 NE 7TH ST",
"city": "TRENTON",
"state": "FL",
"postal_code": "326933637",
"telephone_number": "352-374-5600"
}
],
"practiceLocations": [
{
"address_1": "1001 NE 16th Ave",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "326012511",
"country_code": "US",
"telephone_number": "352-448-9120",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "103 NE 1st St",
"address_purpose": "LOCATION",
"city": "Chiefland",
"state": "FL",
"postal_code": "326260920",
"country_code": "US",
"telephone_number": "352-374-5600 x8860",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHOREY",
"first_name": "JOHN",
"middle_name": "DEVIN",
"credential": "LMHC, RMFTI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-27",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "19625",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "3069",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Trenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.