Shannon Mallory Keegan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11016157 Issued in FL

Practice address

519 N Dixie Fwy
New Smyrna Beach, FL 32168-6707

Phone

(407) 299-7333

NPI assigned

Jan 10, 2022

Last updated

Jul 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Mallory Keegan Former name

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Florida Dermatology Associates P.a.Group PAC ID 1254233786, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mid-Florida Dermatology Associates P.a.

  dba NOLA Dermatology

  • Dermatology Physician
  • Orlando, FL
  • NPI 1619018561
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1427719657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 N DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686707",
            "telephone_number": "386-428-8197",
            "fax_number": "386-428-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686707",
            "telephone_number": "407-299-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEGAN",
        "first_name": "SHANNON",
        "middle_name": "MALLORY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11016157",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11016157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KEEGAN",
            "middle_name": "MALLORY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracey Jones
• Beatriz Leticia Junqueira, MD
• Kanan Medical, LLC (New Smyrna Beach MD)
• Karen Burke LMT
• Andrea Katz, M.D.
• Kimberly Anne Keller, DO
• David K Kelly, CRNA
• Lauren Kennard
• Kristopher Allen Kessler, DC
• Arkadiy Kheyfits, DO

• Family Nurse Practitioner in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.