Mobile Practitioners Group Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MOBILE PRACTITIONERS GROUP INC

Doing business as

Mobile Practitioners Group Inc

Practice address

3363 Dione St
West Melbourne, FL 32904-7582

Phone

(904) 477-3138

NPI assigned

Mar 23, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Shedrick Shields, NURSE PRACTITONERNPI 1902125446

Title

Owner

Phone

(904) 477-3138

Specialties & licenses 1

Addresses

Other names 1

• Mobile Practitioners Group Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shedrick D Shields, PHD, APRN

  • Nurse Practitioner
  • West Melbourne, FL
  • NPI 1902125446
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1841827789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3363 DIONE ST",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329047582",
            "telephone_number": "904-477-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 DIONE ST",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329047582",
            "telephone_number": "904-477-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PRACTITIONERS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "SHEDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-477-3138",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NURSE PRACTITONER"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Practitioners Group Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Merino
• Migun Central, LLC (A Better Way to Health)
• Lindsay Michelle Miller, MSN, APRN, FNP-C
• Rebecca Miller, LMT
• Sara Christine Moallem-Wood, LCSW
• Daniel Moran
• Raquel Morel Mendez
• Joy Cheryl Mullen, COTA
• Heather Mullins
• Jennifer Mumme

• Family Nurse Practitioner in West Melbourne, FL
• Providers in West Melbourne, 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 Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.