Amanda Lee Shoemaker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116456 Issued in FL

Practice address

14534 Old Saint Augustine Rd Ste 3210
Jacksonville, FL 32258-2645

Phone

(904) 675-4000

Fax

(904) 675-4007

NPI assigned

Mar 23, 2022

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

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Spine and Pain Physicians LLCGroup PAC ID 9931092814, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.shoemaker.1@33498.direct.athenahealth.com
• Direct secure messaging: amanda.shoemaker.p1@direct.riversidepain.nextgenshare.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.

• Riverside Spine & Pain Physicians, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1639208648
  Medicare reassignment Care Compare group
• Riverside Spine & Pain Physicians, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1619343886
  NPD

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1902556053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14534 OLD SAINT AUGUSTINE RD STE 3210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582645",
            "telephone_number": "904-675-4000",
            "fax_number": "904-675-4007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5191 First Coast Tech Pkwy Fl 3",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322240609",
            "country_code": "US",
            "telephone_number": "904-675-4000",
            "fax_number": "904-675-4007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116456",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13127",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Shmunes, M.D.
• Summer Shoaf
• Heather M. Shockley, MA
• Jada Rene Shockley, PA-C
• Alexandra Judith Shoemaker, PA-C
• Mary Lynnette Shoffner
• Roseline Oghomwen Shofolu
• Payal Paresh Patel Shooliz, MD
• Pouya Shooliz, M.D.
• Stanvonna Shootes

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.

Verify at the official NPI Registry.