Individual provider Active NPI

Shauna Renae Chaney, AGNP

  • Gerontology Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1780544064
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11043642 Issued in FL
Practice address
12724 Serenade Cir N
Jacksonville, FL 32225-3960
Phone
(407) 873-4328
NPI assigned
Nov 17, 2025
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9540489 FL
Gerontology Nurse Practitioner 363LG0600X APRN11043642 FL Primary

Addresses

Primary practice location

12724 Serenade Cir N
Jacksonville, FL 32225-3960

Mailing address

12724 Serenade Cir N
Jacksonville, FL 32225-3960
Phone (407) 873-4328

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
I20260331003951 FL Practitioner - Nurse Practitioner 7618452251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Coast Surgical Associates Inc.Group PAC ID 5395779359, 31 clinicians

Practice addresses (Care Compare)

6206 Atlantic Blvd
Suite 1
Jacksonville, FL 32211-7560
Phone (904) 731-7131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9540489FLMDRegistered Nurse
APRN11043642FLMDGerontology Nurse Practitioner

Organizations & group practices 1

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.

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": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1780544064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12724 SERENADE CIR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253960",
            "telephone_number": "407-873-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 SERENADE CIR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253960",
            "telephone_number": "407-873-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "SHAUNA",
        "middle_name": "RENAE",
        "name_prefix": "Miss",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9540489",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11043642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.