Jessica Shacklett, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11009058 Issued in FL

Practice address

316 Manatee Ave W
Bradenton, FL 34205-8805

Phone

(941) 748-2277

Fax

(941) 748-1958

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manatee Cardiology Associates LLCGroup PAC ID 9133377500, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035
• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1685

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.

• Manatee Cardiology Associates, LLC

  • Cardiovascular Disease Physician
  • Bradenton, FL
  • NPI 1720341068
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation
• Manatee Memorial Hospital L P

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1760472799
  Care Compare affiliation

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1467067371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S GULPH RD; ATT IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "941-748-2277",
            "fax_number": "941-748-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058805",
            "telephone_number": "941-748-2277",
            "fax_number": "941-748-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLETT",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11009058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111541700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista D Settle, DPT MPT
• Barry Lee Severs, M.D.
• Xavier Diego Sevilla, M.D.
• Wayne Seward Jr., PA-C
• Paul L Sganga
• Gail Shafran, FNP
• M. Mohsin Shah, M.D.
• Neel Shah
• Nishan Anilkumar Shah, MD
• Raj Shah, DO

• Family Nurse Practitioner in Bradenton, FL
• Providers in Bradenton, 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 Nov 3, 2021; 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.