Shire Maria Padao, APRN

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Oxford, FL

NPI 1558098491 · NPPES record last updated Aug 2, 2022

Key facts

NPI
1558098491
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
11021164 (FL)
Practice address
4993 Sandpiper Dr
Oxford, FL 34484-3816
Phone
(630) 997-4455
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230228001886 FL Practitioner - Nurse Practitioner 0345613055

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11021164FLMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: shire.padao.1@24284.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X 11021164 FL Yes

Addresses

Primary practice location

4993 Sandpiper Dr
Oxford, FL 34484-3816

Mailing address

4993 Sandpiper Dr
Oxford, FL 34484-3816
Phone (630) 997-4455

Other providers in Oxford, FL

All providers in Oxford, FL · Psychiatric/Mental Health Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.