Individual provider Active NPI

Shannon Rose Nelson, APRN

  • Family Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1659177376
Registry record updated Feb 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11034493 Issued in FL
Practice address
22524 Middletown Dr
Boca Raton, FL 33428-4709
Phone
(561) 305-6126
NPI assigned
Feb 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11034493 FL
Acute Care Nurse Practitioner 363LA2100X APRN11034493 FL
Community Health Nurse Practitioner 363LC1500X APRN11034493 FL
Pediatric Nurse Practitioner 363LP0200X APRN11034493 FL
Primary Care Nurse Practitioner 363LP2300X APRN11034493 FL
Women's Health Nurse Practitioner 363LW0102X APRN11034493 FL
Adult Health Nurse Practitioner 363LA2200X APRN11034493 FL
Family Nurse Practitioner 363LF0000X APRN11034493 FL Primary

Addresses

Primary practice location

22524 Middletown Dr
Boca Raton, FL 33428-4709

Mailing address

22524 Middletown Dr
Boca Raton, FL 33428-4709
Phone (561) 305-6126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11034493FLMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: shannon.nelson@809235966787588.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1740182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1659177376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22524 MIDDLETOWN DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284709",
            "telephone_number": "561-305-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22524 MIDDLETOWN DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284709",
            "telephone_number": "561-305-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHANNON",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-22",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11034493",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11034493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.