Shantell Polidor, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11018822 Issued in FL

Practice address

6841 Blanding Blvd
Jacksonville, FL 32244-4418

Phone

(904) 862-2175

NPI assigned

Mar 25, 2022

Sex

Female

Sole proprietor

No

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heal Precisely of Northside LLCGroup PAC ID 9537544853, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Heal Precisely of Northside LLC

  • General Practice Physician
  • St Petersburg, FL
  • NPI 1093433674
  Medicare reassignment Care Compare group NPD
• Cardiac Vision LLC

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1144651373
  Medicare reassignment NPD
• Saberi Advanced Wound Care LLC

  • Family Medicine Physician
  • St Petersburg, FL
  • NPI 1578264818
  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• Wound Technology Network Inc

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1962601393
  Medicare reassignment NPD
• WT Health of Florida LLC

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1982434106
  Medicare reassignment NPD
• Elements Therapy Partners LLC

  • Internal Medicine Physician
  • Boca Raton, FL
  • NPI 1710830104
  Medicare reassignment
• Transitions Healthcare LLC

  • Internal Medicine Physician
  • Clearwater, FL
  • NPI 1821707407
  Medicare reassignment
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Symphony Specialty Group, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1831878735
  NPD

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1770233579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5752 ROVER DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322441430",
            "telephone_number": "904-713-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322444418",
            "telephone_number": "904-862-2175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5752 Rover Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322441430",
            "country_code": "US",
            "telephone_number": "904-713-7428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLIDOR",
        "first_name": "SHANTELL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11018822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Nicole Polanco
• Shanaed Markia Poland
• Camilo Andres Polania Sandoval, MD
• Chelsee Pole
• Anitha Police, MD
• Adam J Polifka, MD
• Ryan David Poling, MD
• Taylor Poling
• Laura Beth Polinsky, PHARMD
• Richard I Polisner, D.P.M.

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.