Individual provider Active NPI

Leanne E Jacquemin, CRNA

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1548668684
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9309141 Issued in FL
Practice address
449 W 23Rd St
Panama City, FL 32405-4507
Phone
(850) 747-7183
Fax
(850) 785-6233
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9309141 FL
Certified Registered Nurse Anesthetist 367500000X ARNP9309141 FL Primary

Addresses

Primary practice location

449 W 23Rd St
Panama City, FL 32405-4507

Mailing address

7700 W Sunrise Blvd
Mailstop PL-14 2ND FL
Plantation, FL 33322-4113
Phone (954) 939-2371

Other names 1

  • Leanne E Shapard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528001757 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719207018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

449 W 23Rd St
Panama City, FL 32405-4507
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9309141FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Jan 1, 2018 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 29, 2015 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 6

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 1

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1548668684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 W SUNRISE BLVD",
            "address_2": "MAILSTOP PL-14 2ND FL",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224113",
            "telephone_number": "954-939-2371",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054507",
            "telephone_number": "850-747-7183",
            "fax_number": "850-785-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUEMIN",
        "first_name": "LEANNE",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9309141",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9309141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANNE",
            "last_name": "SHAPARD",
            "middle_name": "E",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.