Individual provider Active NPI

Shannon Christie Gummoe, APRN

  • Family Nurse Practitioner
  • Trinity, FL
National Provider Identifier
1568021343
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002636 Issued in FL
Practice address
9330 State Road 54
Trinity, FL 34655-1808
Phone
(727) 834-4000
NPI assigned
Jun 6, 2019
Last updated
Jun 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002636 FL Primary

Addresses

Primary practice location

9330 State Road 54
Trinity, FL 34655-1808

Mailing address

9330 State Road 54
Trinity, FL 34655-1808
Phone (727) 834-4000

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
I20190828001390 FL Practitioner - Nurse Practitioner 2567790678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Hospital Family Practice LLCGroup PAC ID 2264595941, 44 clinicians

Practice addresses (Care Compare)

9332 State Rd
54 Suite 400
Trinity, FL 34655-1810
Phone (727) 372-4779

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.95 of 100Reported as group
Quality
78.21
Promoting interoperability
100
Improvement activities
40
Cost
77.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Family Practice LLC CurrentSince Dec 19, 2022 Accepting new patients

Locations

7515 State Road 52
Ste 102
Hudson, FL 34667
Phone (727) 842-3322

6500 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-4870

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

9332 State Road 54
Ste 400
Trinity, FL 34655
Phone (727) 372-4779

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: shannon.gummoe@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1568021343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 STATE ROAD 54",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551808",
            "telephone_number": "727-834-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 STATE ROAD 54",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551808",
            "telephone_number": "727-834-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMOE",
        "first_name": "SHANNON",
        "middle_name": "CHRISTIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.