Individual provider Active NPI

Shannon Murphy Carrasco, ARNP

  • Primary Care Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1790142511
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP9181013 Issued in FL
Practice address
26540 Ace Ave Ste 108C
Leesburg, FL 34748-8279
Phone
(352) 326-5281
Fax
(352) 323-1761
NPI assigned
Jan 25, 2016
Last updated
Feb 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP9181013 FL Primary

Addresses

Primary practice location

26540 Ace Ave Ste 108C
Leesburg, FL 34748-8279

Mailing address

26540 Ace Ave Ste 108C
Leesburg, FL 34748-8279
Phone (352) 326-5281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401000051 FL Practitioner - Nurse Practitioner 2860799178 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
To Your Health of Lake County Inc CurrentSince Feb 1, 2016 Accepting new patients
Aegis Medical Group LLC PastSince Sep 12, 2022 Accepting new patients

Locations

26540 Ace Ave
Ste 108C
Leesburg, FL 34748
Phone (352) 323-4800

4700 That St
Leesburg, FL 34748
Phone (352) 326-5281

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1790142511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE STE 108C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-326-5281",
            "fax_number": "352-323-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE STE 108C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-326-5281",
            "fax_number": "352-323-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "SHANNON",
        "middle_name": "MURPHY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9181013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.