Individual provider Active NPI

Shahira Hanna, MD

  • Obstetrics & Gynecology Physician
  • Pensacola, FL
National Provider Identifier
1720025968
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME167014 Issued in FL
Practice address
1657 Trinity Dr
Pensacola, FL 32504-5708
Phone
(850) 416-2400
Fax
(850) 416-2330
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME167014 FL Primary

Addresses

Primary practice location

1657 Trinity Dr
Pensacola, FL 32504-5708

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other identifiers 1

IdentifierTypeStateIssuer
00114485MedicaidMS

Other names 1

  • Shahira H Kenealy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041201000532 MS Practitioner - Obstetrics/Gynecology 8729043773 Reassigns benefits to 1 organization
I20240809000720 FL Practitioner - Obstetrics/Gynecology 8729043773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Perelman School of Med at the University of Pennsylvania, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

1657 Trinity Dr
Pensacola, FL 32504-5708
Phone (850) 416-0086

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME167014FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Mar 15, 2021 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Mar 15, 2021 Accepting new patients
Escambia Community Clinics Inc CurrentSince Oct 1, 2024 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Escambia Community Clinics Inc Current Accepting new patients
Escambia Community Clinics, Inc CurrentSince Oct 1, 2024 Accepting new patients
Sacred Heart Health System Inc CurrentSince Jun 1, 2024 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Ochsner Mississippi, LLC PastSince Mar 7, 2021 Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

5520 Stewart St
Milton, FL 32570
Phone (850) 891-9433

1657 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-2400

2315 W Jackson St
Pensacola, FL 32505
Phone (850) 495-3955

5045 Carpenter Creek Dr
Pensacola, FL 32503
Phone (850) 416-2400

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

Interoperability endpoints

  • Direct secure messaging: shanna@direct.mhg.com
  • Direct secure messaging: shahira.hanna.1@9582.direct.athenahealth.com

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1720025968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 TRINITY DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045708",
            "telephone_number": "850-416-2400",
            "fax_number": "850-416-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "SHAHIRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME167014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114485",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAHIRA",
            "last_name": "KENEALY",
            "middle_name": "H",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.