Individual provider Active NPI

Shannon Eileen McKaig, ARNP

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1750642773
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2058032 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-0076
Fax
(352) 265-1104
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2058032 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 918025
Orlando, FL 32891-0001
Phone (352) 265-0076

Other identifiers 1

IdentifierTypeStateIssuer
005963900MedicaidFL

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
I20120920000403 FL Practitioner - Nurse Practitioner 9537317334 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2058032FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Care, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Aug 18, 2012 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Aug 18, 2012 Accepting new patients
Rural Health Care Incorporated Current Accepting new patients
Rural Health Care, Incorporated CurrentSince Apr 1, 2022 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1213 State Road 20
Interlachen, FL 32148
Phone (386) 684-2407

100 Commercial Dr
Keystone Hgts, FL 32656
Phone (352) 473-6595

1302 River St
Palatka, FL 32177
Phone (386) 328-0108

Interoperability endpoints

  • Direct secure messaging: shannon.mckaig.p1@direct.azahealth.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1750642773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "352-265-0076",
            "fax_number": "352-265-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0076",
            "fax_number": "352-265-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAIG",
        "first_name": "SHANNON",
        "middle_name": "EILEEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2058032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005963900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.