Shana McCloud, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11011966 Issued in FL

Practice address

5011 Gate Parkway
BLDG 100 Ste 100
Jacksonville, FL 32256-3225

Phone

(904) 512-7239

Fax

(866) 380-0827

NPI assigned

Mar 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kopa LLCGroup PAC ID 5193774461, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Kopa LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
  • NPI 1417021114
  Medicare reassignment Care Compare group NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1679150338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 GATE PARKWAY",
            "address_2": "BLDG 100 SUITE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560830",
            "telephone_number": "904-512-7239",
            "fax_number": "866-380-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 GATE PARKWAY",
            "address_2": "BLDG 100 STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563225",
            "telephone_number": "904-512-7239",
            "fax_number": "866-380-0827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5720 Fairbridge St",
            "address_purpose": "LOCATION",
            "city": "Cocoa",
            "state": "FL",
            "postal_code": "329272255",
            "country_code": "US",
            "telephone_number": "321-549-9026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLOUD",
        "first_name": "SHANA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "APRN11011966",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "APRN11011966",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter McClinton, MS
• Nicole Alyson McClone, DPT
• Abigail Grace McCloskey
• Erica McCloud, MASTER LEVEL
• Jossie Aliyah McCloud, D.O.
• Jason R McClune, MD
• David McClung, PHARM. D.
• Laura Harvey McClung, ARNP
• Erica McClure
• James McClure

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, 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 Aug 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.