Active NPI
William M Shimp, PA-C
- Surgical Physician Assistant
- St Augustine, FL
National Provider Identifier
1821092511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA9101052
- Practice address
- 300 Health Park Blvd Ste 5008
St Augustine, FL 32086-3705 - Phone
- (904) 494-2394
- Fax
- (904) 400-6676
- NPI assigned
- Jun 9, 2005
- Last updated
- May 15, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA9101052 | FL | Primary |
| Physician Assistant | 363A00000X | PA9101052 | FL |
Addresses
Primary practice location
300 Health Park Blvd Ste 5008
St Augustine, FL 32086-3705
Mailing address
1824 King St Ste 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343
Other practice location 1
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124917400 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615
400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 823-1447
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9101052 | FL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients |
Locations
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- wshimp2448268@ehrdirect.mayoclinicmsg.org
- williamshimp@cvsapa.allscriptsdirect.net
- wshimp744561@direct.shands.ufl.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1790772317
-
- Surgery Physician
- Leesburg, FL
- NPI 1700669926
-
- Vascular & Interventional Radiology Physician
- Jacksonville, FL
- NPI 1851403125
-
dba Mayo Clinic Home Infusion Pharmacy
- Home Infusion Therapy Pharmacy
- Jacksonville, FL
- NPI 1003510116
-
dba MCF Integrative Medicine and Health
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1871054106
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- St Augustine, FL
- NPI 1144211020
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1891782470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778803200000",
"number": "1821092511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1824 KING ST STE 200",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322044736",
"telephone_number": "904-384-3343",
"fax_number": "904-400-6671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HEALTH PARK BLVD STE 5008",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320863705",
"telephone_number": "904-494-2394",
"fax_number": "904-400-6676"
}
],
"practiceLocations": [
{
"address_1": "4500 San Pablo Rd S",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322241865",
"country_code": "US",
"telephone_number": "904-953-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIMP",
"first_name": "WILLIAM",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2026-05-15",
"certification_date": "2026-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9101052",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9101052",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124917400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.