Sara Shanahan, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

ARNP9356720 Issued in FL

Practice address

11100 Summer Ridge Lane
Fort Myers, FL 33908-4064

Phone

(239) 344-2348

Fax

(239) 479-5194

NPI assigned

Jan 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Raulerson GYN LLCGroup PAC ID 9335213388, 7 clinicians

Hendry County Hospital AuthorityGroup PAC ID 8022912435, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: sara.shanahan@hca4.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hendry County Hospital Authority

  dba Hendry Regional Physicians Group

  • Specialist
  • Clewiston, FL
  • NPI 1356360424
  Medicare reassignment Care Compare group NPD
• Raulerson GYN LLC

  • Obstetrics Physician
  • Okeechobee, FL
  • NPI 1356528210
  Medicare reassignment Care Compare group NPD
• Hendry County Hospital Authority

  dba Hendry Regional Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Clewiston, FL
  • NPI 1336937408
  NPD
• Hendry County Hospital Authority

  dba Hendry Regional Convenient Care Center

  • Rural Health Clinic/Center
  • Labelle, FL
  • NPI 1588859623
  NPD

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1871001370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919771",
            "telephone_number": "239-278-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SUMMER RIDGE LANE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084064",
            "telephone_number": "239-344-2348",
            "fax_number": "239-479-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "SARA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP9356720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023637900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "JG996Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shalimare Inc.
• Shalom Behavioral Wellness Center LLC.
• Isabella Mukanda Shamambo
• Khadijah Fatimah Shamseddine, M.D.
• Ryan J. Shamus, P.A.
• Tamelyn Shane
• Cynthia Ann Shannon
• Dianna Marie Shannon, FNP-C
• Frederick Brett Shannon, D.O.
• Janet Muth Shannon, PT

• Advanced Practice Midwife in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Advanced Practice Midwife in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.

Verify at the official NPI Registry.