Organization Active NPI

Procare NP Eclinic, LLC

  • Family Nurse Practitioner
  • Sheridan, WY
National Provider Identifier
1659949683
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PROCARE NP ECLINIC, LLC
Practice address
1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777
Phone
(307) 461-5080
NPI assigned
Jun 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Authorized official

Name
Sharanna Sharmel Johnson, FNPNPI 1538672126
Title
Nurse Practitioner
Phone
(321) 343-7008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777

Mailing address

9998 Eagle Creek Center Blvd
Orlando, FL 32832-6333

Other identifiers 1

IdentifierTypeStateIssuer
0000000OtherNONE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@procarenpclinic.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220205000141 FL Part B Supplier - Clinic/Group Practice 9234522756 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1659949683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9998 EAGLE CREEK CENTER BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE STE 1200",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777",
            "telephone_number": "307-461-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE NP ECLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHARANNA",
        "authorized_official_middle_name": "SHARMEL",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "321-343-7008",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@procarenpclinic.com",
            "affiliation": "N",
            "address_1": "1309 Coffeen Ave Ste 1200",
            "city": "Sheridan",
            "state": "WY",
            "country_code": "US",
            "postal_code": "828015777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.