Sarah Shine

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

4243 Sunbeam Road
Floor 1 Ste 6
Jacksonville, FL 32257-8957

Phone

(617) 379-0496

NPI assigned

Apr 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1700405214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042534",
            "telephone_number": "904-387-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 SUNBEAM ROAD",
            "address_2": "FLOOR 1 STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578957",
            "telephone_number": "617-379-0496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Stockton St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322042534",
            "country_code": "US",
            "telephone_number": "904-387-4661 x1083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINE",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshine@gatewaycommunity.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "555 Stockton St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322042534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah.shine@thriveworks.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4243 Sunbeam Road",
            "address_2": "Floor 1 Ste 6",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322578957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen S Shimshak, MD
• Serena Jane Elizabeth Shimshak, MD
• Yakov Shimunov, DDS
• Junghye Shin, AU.D.
• Dionna Shine, PHARMD
• Timothy Shine, MD
• Tracy Shingle-Bratton
• Shining Light Peer Services
• Shining Stars Applied Behavior Analysis Corp.
• Shinymax

• Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.