Shanice Baker
Individual provider Active NPI Family Nurse Practitioner · Celebration, FL
NPI 1700628682 · NPPES record last updated Jul 17, 2024
Key facts
- NPI
- 1700628682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9452549 (FL)
- Practice address
- 410 Celebration PL Ste 208
Celebration, FL 34747-5434 - Phone
- (877) 800-0239
- Fax
- (407) 566-2499
- NPI assigned
- Jun 11, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Florida Woman Care LLC
Practice addresses (Care Compare)
410 Celebration PL
Suite 208
Celebration, FL 34747-5434
Phone (561) 300-2410
Hospital & facility affiliations
- Adventhealth Orlando
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240731001914 | FL | Practitioner - Nurse Practitioner | 1355888017 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9452549 | FL | MD | Family Nurse Practitioner |
Practice roles (2 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Woman Care, LLC | Current |
Accepting new patients | |
| Womencare PA | Past | Accepting new patients |
Locations
2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233
2209 North Blvd W
Ste C
Davenport, FL 33837
Phone (407) 566-2229
112 Park Place Blvd
Davenport, FL 33837
Phone (407) 343-1825
1201 E Oak St
Kissimmee, FL 34744
Phone (407) 566-2229
410 Celebration Pl
Ste 208
Kissimmee, FL 34747
Phone (407) 566-2229
3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814
1997 Daniels Rd
Winter Garden, FL 34787
Phone (407) 566-2229
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- shanice.baker.1@2183.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9452549 | FL | Yes |
Addresses
Primary practice location
410 Celebration PL Ste 208
Celebration, FL 34747-5434
Mailing address
410 Celebration PL Ste 208
Celebration, FL 34747-5434
Phone (877) 800-0239
Other practice location 1
1997 Daniles Road
Winter Garden, FL 34787-4599
Phone (877) 800-0239
Other practice location 2
2209 North Boulevard West
Ste C
Davenport, FL 33837-8903
Phone (877) 800-0239
Other providers in Celebration, FL
- James Sutlive Atkins Jr.
- Aurora Therapy Services PLLC
- Mohammed Masfikul Azam
- Trevor Rossi Baddaloo
- Maria Imelda Matondo Baguia
- Alan Bako
- Luis Emilio Baltodano
- Beth Sarah Barbara
- Barefoot Perspectives PLLC
- Miranda Jean Barker
All providers in Celebration, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.