Individual provider Active NPI

Eddy Shane Thomas, ARNP

  • Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1609326537
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9237428 Issued in FL
Practice address
300 Health Park Blvd Ste 4000
St Augustine, FL 32086-3704
Phone
(904) 824-8666
Fax
(904) 824-8933
NPI assigned
Oct 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9237428 FL
Nurse Practitioner 363L00000X APRN9237428 FL Primary

Addresses

Primary practice location

300 Health Park Blvd Ste 4000
St Augustine, FL 32086-3704

Mailing address

PO Box 100225
Gainesville, FL 32610-0225
Phone (352) 273-8737

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 273-8737

Other practice location 2

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (352) 323-5762

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
I20161117002138 FL Practitioner - Nurse Practitioner 9234418070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary Associates of StGroup PAC ID 0749240018, 11 clinicians

Practice addresses (Care Compare)

300 Health Park Blvd
Suite 4000
St Augustine, FL 32086-3704
Phone (904) 824-8666

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 824-8666

Hospital & facility affiliations

  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

Merit-based Incentive Payment System (MIPS)

Final score
97.68 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9247428FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Associates of St CurrentSince Oct 1, 2016 Accepting new patients

Locations

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

300 Health Park Blvd
Ste 4000
St Augustine, FL 32086
Phone (904) 824-8666

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1609326537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100225",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100225",
            "telephone_number": "352-273-8737",
            "fax_number": "352-265-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD STE 4000",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863704",
            "telephone_number": "904-824-8666",
            "fax_number": "904-824-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-273-8737",
            "fax_number": "352-273-9154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485925",
            "country_code": "US",
            "telephone_number": "352-323-5762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "EDDY",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-04",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9237428",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9237428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.