Individual provider Active NPI

Shakisha Lawson, APRN, FNP

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1891347118
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002610 Issued in FL
Practice address
Bay Pines VA Hospital
10000 Bay Pines Blvd
Saint Petersburg, FL 33744
Phone
(727) 398-6661
NPI assigned
Jul 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002610 FL Primary

Addresses

Primary practice location

Bay Pines VA Hospital
10000 Bay Pines Blvd
Saint Petersburg, FL 33744

Mailing address

4216 W la Salle St
Tampa, FL 33607-4115
Phone (813) 580-9599

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205001326 FL Practitioner - Nurse Practitioner 2466888771 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upperline Healthcare PCGroup PAC ID 4385900653, 194 clinicians

Practice addresses (Care Compare)

21 Hospital Dr
Suite 170a
Palm Coast, FL 32164-2454
Phone (386) 586-7373

3491 Gandy Blvd N
Suite 107
Pinellas Park, FL 33781-2652
Phone (727) 384-5540

819 E Oak St
Suite B
Kissimmee, FL 34744-5842
Phone (407) 846-1234

922 E Call St
Starke, FL 32091-3616
Phone (904) 368-2328

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002610FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Ageless Center LLC CurrentSince Aug 14, 2025 Accepting new patients

Locations

555 W Granada Blvd
Ste E2
Ormond Beach, FL 32174
Phone (386) 235-6136

1300 Peachtree Industrial Blvd
Ste 1201
Suwanee, GA 30024
Phone (770) 614-6266

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1891347118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 W LA SALLE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336074115",
            "telephone_number": "813-580-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAY PINES VA HOSPITAL",
            "address_2": "10000 BAY PINES BLVD",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "33744",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "SHAKISHA",
        "credential": "APRN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.