Individual provider Active NPI

Sandra Jean Schellhorn, NP

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1497928089
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2139162 Issued in FL
Practice address
836 Prudential Dr
Suite 1601
Jacksonville, FL 32207
Phone
(904) 861-7804
NPI assigned
Apr 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2139162 FL Primary

Addresses

Primary practice location

836 Prudential Dr
Suite 1601
Jacksonville, FL 32207

Mailing address

836 Prudential Drive
Suite 1601
Jacksonville, FL 32207
Phone (904) 861-7804

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101020000314 FL Practitioner - Nurse Practitioner 4789877945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

2300 Park Ave
101B
Orange Park, FL 32073-5572
Phone (904) 264-0088

Hospital & facility affiliations

  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2139162FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Aug 14, 2017 Accepting new patients
St Vincents Medical Center Inc CurrentSince Dec 2, 2018 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Aug 14, 2017 Accepting new patients
St Vincents Medical Center Inc CurrentSince Dec 2, 2018 Accepting new patients
Florida Physicians & Research Assoc Past Accepting new patients

Locations

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372

1658 St Vincents Way
Ste 300
Middleburg, FL 32068
Phone (904) 276-5100

1658 St Vincents Way
Ste 310
Middleburg, FL 32068
Phone (904) 308-2006

2300 Park Ave
Ste 101B
Orange Park, FL 32073
Phone (904) 249-4888

300 Saint Elizabeth Way
Ste 110
St Johns, FL 32259
Phone (904) 691-9100

Interoperability endpoints

  • Direct secure messaging: sandra.schellhorn.1@8967.direct.athenahealth.com

Organizations & group practices 5

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 2

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": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1497928089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DRIVE",
            "address_2": "SUITE 1601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-861-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR",
            "address_2": "SUITE 1601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-861-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLHORN",
        "first_name": "SANDRA",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "2139162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.