Shurine L Nichols, NURSE PRACTITONER

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AG07190314 Issued in FL

Practice address

3109 Strawberry LN
Lakeland, FL 33801-9233

Phone

(305) 527-6666

NPI assigned

Aug 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psynergy Health Med PLLCGroup PAC ID 0749714707, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Psynergy Health Med PLLC

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1891513420
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1730737370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "KATHLEEN",
            "state": "FL",
            "postal_code": "338491137",
            "telephone_number": "305-527-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 STRAWBERRY LN",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338019233",
            "telephone_number": "305-527-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SHURINE",
        "middle_name": "L",
        "credential": "NURSE PRACTITONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "AG07190314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quynh Tram Nhu Nguyen, D.P.M.
• Shon Nguyen, RDN
• Toan Thien Nguyen, M.D.
• Nic 5 Lake Morton Plaza Leasing LLC
• Richard D Nichols, M.D.
• Anne-Marie Caroline Nicolas
• Selena Sabine Nicotra, DO
• Emilee Rebecca Niekro, CRNA
• Matthew Grant Nier, DO
• Isabella Nieto, MD

• Primary Care Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.