Shannon Thor Pollard, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

9478758 Issued in FL

Practice address

925 N Stone St
Deland, FL 32720-2521

Phone

(386) 734-6007

Fax

(386) 734-6008

NPI assigned

Mar 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Ord Physiatry, PC

  • Physical Medicine & Rehabilitation Physician
  • Lake Katrine, NY
  • NPI 1437386414

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1548765993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-6007",
            "fax_number": "386-734-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-6007",
            "fax_number": "386-734-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "SHANNON",
        "middle_name": "THOR",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9478758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Scott Pitchford, HAS
• John William Pittman II, DDS
• Jessica Plate, LSW
• Justin Platt, COTA
• Aleasha Renee Polanco-Monroe
• Lisa Brannen Pompa, LMHC
• Andrew Thomas Portal, D.C.
• Debbie L. Porter, LMHC
• Jerome J Porter
• Robert Wagner Poss, DC

• Gerontology Nurse Practitioner in Deland, FL
• Providers in Deland, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.