Shelby L Lueders, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9113408 Issued in FL

Practice address

3581 SW Archer Rd Ste 40
Gainesville, FL 32608-2428

Phone

(352) 888-4449

NPI assigned

Jun 26, 2014

Last updated

Feb 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, OK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Shands/Solantic Joint Venture, LLC

  • Urgent Care Clinic/Center
  • Gainesville, FL
  • NPI 1558595223
  Medicare reassignment
• Mercy Oklahoma Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Moore, OK
  • NPI 1922509173
  Medicare reassignment
• Shands/Solantic Joint Venture, LLC

  dba CareSpot-Archer Road

  • Urgent Care Clinic/Center
  • Gainesville, FL
  • NPI 1346915295
  NPD

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1902211170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 SW 97TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084667",
            "telephone_number": "563-357-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 SW ARCHER RD STE 40",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326082428",
            "telephone_number": "352-888-4449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Lillian Way",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "527322001",
            "country_code": "US",
            "telephone_number": "563-243-1200",
            "fax_number": "563-242-0671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUEDERS",
        "first_name": "SHELBY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "074722",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Lucien
• Ann Lucke-Wold, APRN
• Brandon Lucke-Wold, MD, PHD
• Laura Norden Lucke, LCSW
• Jessica Ludlow
• Christine Luengo
• Charles W. Luetke, MD
• Ryan Michael Luevanos, MD
• Daniel Omar Lugo Rodriguez, PHARMD
• Daphine Lugo, PSYD

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.