Shawndolyn Bruten

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11008739 Issued in FL

Practice address

325 S Segrave St
Daytona Beach, FL 32114-4815

Phone

(386) 868-6180

NPI assigned

Sep 29, 2020

Last updated

Sep 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  FL

  Medicare reassignment NPD
• Wound Technology Network Inc

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1962601393
  Medicare reassignment

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1629685060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3731",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327213731",
            "telephone_number": "386-868-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S SEGRAVE ST",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144815",
            "telephone_number": "386-868-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUTEN",
        "first_name": "SHAWNDOLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11008739",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara L Brownfield, ARNP
• Teresa M Broxton
• Tony L Broxton
• Bruce C. Benedictson, D.D.S. PA
• Sarah Bruce, ARNP
• Bryan M Bergens DDS PA
• Tenisha Bryan Morris
• Lisa Tracy Ann Bryan Ukawuilulu, APRN
• James M Bryan, MD
• Tara Kelly Bryan, CRNA

• Family Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.