Shenandoah Medical Care Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2602122 Issued in FL

Legal business name

SHENANDOAH MEDICAL CARE CENTER

Practice address

6313 Lansdowne Cir
Boynton Beach, FL 33472-5108

Phone

(561) 853-7233

NPI assigned

Apr 4, 2014

Organization subpart

No

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

Authorized official

Name

Miss Joy L Fuller

Title

Arnp

Phone

(561) 853-7233

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shenandoah Medical Care Center

  • Primary Care Clinic/Center
  • Lantana, FL
  • NPI 1417494154

  O20230712004163

  Same enrollment

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1740608801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6313 LANSDOWNE CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334725108",
            "telephone_number": "561-853-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6313 LANSDOWNE CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334725108",
            "telephone_number": "561-853-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH MEDICAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "561-853-7233",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "2602122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720228208",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gilberto Hernan Shek, MD
• Lillian Wanda Sheldon-Reece, LCSW
• Elizabeth Ronan Sheldon, APRN FNP-C
• Allyson Sheldt
• Michael Lawrence Shelling, M.D.
• George Shenouda, DO
• Patrick P Shepherd, DDS
• Sheridan Healthcorp Inc
• Sheridan Healthcorp Inc
• Sheridan Healthcorp Inc

• Primary Care Clinic/Center in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.