Individual provider Active NPI

Shelita Dunlap

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1801264577
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9413515 Issued in FL
Practice address
10023 S US Highway 1 Ste a
Port St Lucie, FL 34952-5643
Phone
(772) 398-5339
NPI assigned
Sep 10, 2015
Last updated
Jan 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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 9413515 FL Primary

Addresses

Primary practice location

10023 S US Highway 1 Ste a
Port St Lucie, FL 34952-5643

Mailing address

10023 S US Highway 1 Ste a
Port St Lucie, FL 34952-5643
Phone (772) 398-5339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MD2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160422000530 FL Practitioner - Nurse Practitioner 1355640590
I20230214000492 MD Practitioner - Nurse Practitioner 1355640590 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9413515FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shelita Dunlap LLC Nurse Practitioner Current Accepting new patients
Associates in Medicine, LLC PastSince Oct 1, 2003 Accepting new patients

Locations

2201 S 25th St
Fort Pierce, FL 34947
Phone (772) 461-3466

Organizations & group practices 3

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": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1801264577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10023 S US HIGHWAY 1 STE A",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525643",
            "telephone_number": "772-398-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10023 S US HIGHWAY 1 STE A",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525643",
            "telephone_number": "772-398-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNLAP",
        "first_name": "SHELITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9413515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.