Individual provider Active NPI

Shana Marks-Henry

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1619755188
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11028475 Issued in FL
Practice address
123 Baptist Way
Pensacola, FL 32503-2254
Phone
(850) 434-4011
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 APRN11028475 FL Primary

Addresses

Primary practice location

123 Baptist Way
Pensacola, FL 32503-2254

Mailing address

5332 Willow Oak Dr
Pace, FL 32571-6279
Phone (770) 728-2611

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
I20240104000151 FL Practitioner - Nurse Practitioner 2668823600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

1044 E Brandon Blvd
Suite 1And2
Brandon, FL 33511-5509
Phone (813) 403-4423

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Luisa Vega DNP LLC CurrentSince Nov 6, 2023 Accepting new patients

Locations

1044 E Brandon Blvd
Ste 12
Brandon, FL 33511
Phone (813) 403-4423

525 Technology Park
Lake Mary, FL 32746
Phone (407) 347-4331

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

Organizations & group practices 2

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1619755188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 WILLOW OAK DR",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325716279",
            "telephone_number": "770-728-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BAPTIST WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032254",
            "telephone_number": "850-434-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS-HENRY",
        "first_name": "SHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11028475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.