Individual provider Active NPI

Shelley Ann George, APRN

  • Adult Health Nurse Practitioner
  • New Smyrna Beach, FL
National Provider Identifier
1710149539
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP1916522 Issued in FL
Practice address
600 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone
(386) 424-3850
Fax
(386) 424-3851
NPI assigned
Jul 2, 2008
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X ARNP1916522 FL
Adult Health Nurse Practitioner 363LA2200X ARNP1916522 FL Primary

Addresses

Primary practice location

600 Palmetto St
New Smyrna Beach, FL 32168-7327

Mailing address

408 Bushnell Park CT
Ormond Beach, FL 32174-2664
Phone (813) 500-0597

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120911000238 FL Practitioner - Nurse Practitioner 1355599721 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nautilus Health Care Group, LLC Undersea and Hyperbaric Medicine CurrentSince Nov 2, 2020 Accepting new patients
Nautilus Health Care Group LLC Undersea and Hyperbaric Medicine CurrentSince Nov 2, 2020 Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

600 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-3850

600 Palmetto St
#5
New Smyrna Beach, FL 32168
Phone (386) 424-3850

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1710149539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 BUSHNELL PARK CT",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742664",
            "telephone_number": "813-500-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-424-3850",
            "fax_number": "386-424-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "SHELLEY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ARNP1916522",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP1916522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.