Jessica K Shutt, RNCS

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

9410846 Issued in FL

Practice address

2725 Rebecca LN Ste 107
Orange City, FL 32763-8350

Phone

(386) 775-0736

Fax

(386) 775-0738

NPI assigned

May 5, 2008

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Neurobehavioral Associates III, Inc

  • Geriatric Psychiatry Physician
  • Weymouth, MA
  • NPI 1205926946

  Psychiatric/Mental Health, Adult

  NPD (past)

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1700052214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 REBECCA LN STE 107",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638350",
            "telephone_number": "386-775-0736",
            "fax_number": "386-775-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 REBECCA LN STE 107",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638350",
            "telephone_number": "386-775-0736",
            "fax_number": "386-775-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTT",
        "first_name": "JESSICA",
        "middle_name": "K",
        "credential": "RNCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "233581",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "FL",
            "license": "9410846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neeraj Sharma, MD
• Olivia Shenkle
• Kelly Sherwin
• Natalia Deepak Shringarpure, MD
• Kishorkumar N Shukla, MD
• Sarah Sidhom, DMD
• Marlene Silver, RN
• Janiyah Simmons
• Simonmed Imaging Florida LLC (Simonmed Imaging Orange City)
• Jennifer Ann Sinclair, MD

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Orange City, FL
• Providers in Orange City, FL by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.