Gregory C Shedlock

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS21040 Issued in FL

Practice address

919 53Rd Ave E
Bradenton, FL 34203-4801

Phone

(941) 751-8100

Fax

(941) 751-8127

NPI assigned

Mar 22, 2021

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Lake Erie Col of Osteopathic Medicine, Bradenton, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCR Health IncGroup PAC ID 7214847995, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Healthcare at Home Home health agency, Bradenton, FL, CCN 107656
• Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregory.shedlock.1@11352.direct.athenahealth.com
• Direct secure messaging: gregory.shedlock@hca4.eclinicaldirectplus.com

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.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment Care Compare group NPD
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• MCR Health, Inc.

  dba North Manatee Family Healthcare Center

  • Federally Qualified Health Center (FQHC)
  • Palmetto, FL
  • NPI 1841236247

  Internal Medicine

  NPD (past)

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

• Hestia Healthcare at Home, LLC

  dba HCA Florida Healthcare at Home

  • Home Health Agency
  • Bradenton, FL
  • NPI 1194874776
  Care Compare affiliation
• Manatee Memorial Hospital L P

  dba Manatee Memorial Hospital

  • 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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1528644333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034801",
            "telephone_number": "941-751-8100",
            "fax_number": "941-751-8127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 59th St W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342094604",
            "country_code": "US",
            "telephone_number": "941-798-6513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEDLOCK",
        "first_name": "GREGORY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-08-06",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS21040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malery Shashidhara, MD
• Marissa Saladeen Shatkin, LMHC
• Angela Marie Shattuck, ARNP
• Amanda Shaw, MA, LMHC
• Lynne Mason Shay, M.A.
• Jennifer Sue Sheehan, COTA/L
• Rosabella Shek, MD
• John C Shelton, M.D.
• Holly Hobbs Shen, M.D.
• Sheplak Dental PLLC

• Internal Medicine Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.