Individual provider Active NPI

Shelly Marilyn McLaren, MD

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1679777577
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 98527 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 975-0412
Fax
(407) 975-0413
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 98527 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 975-0412

Other identifiers 1

IdentifierTypeStateIssuer
001645700MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110711000457 FL Practitioner - Pediatric Medicine 8325226608 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 98527FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 3, 2020 Accepting new patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Aug 3, 2020 Accepting new patients
Pediatric Physician Services, Inc. Pediatrics CurrentSince May 14, 2018 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

601 5th St S
St Petersburg, FL 33701
Phone (727) 767-3333

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

Interoperability endpoints

  • Direct secure messaging: smclaren733379@direct.hopkinsmedicine.org
  • Direct secure messaging: smclaren127747@adventhealth.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1679777577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-975-0412",
            "fax_number": "407-975-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-975-0412",
            "fax_number": "407-975-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAREN",
        "first_name": "SHELLY",
        "middle_name": "MARILYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 98527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001645700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.