Shiney Alex Jacob, PHD, DNP, MSHI, MPH,

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11031671 Issued in FL

Practice address

366 Brentwood Club CV
Longwood, FL 32750-3352

Phone

(321) 527-9025

NPI assigned

Oct 14, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1942020185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 BRENTWOOD CLUB CV",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503352",
            "telephone_number": "321-527-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 BRENTWOOD CLUB CV",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503352",
            "telephone_number": "321-527-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SHINEY",
        "middle_name": "ALEX",
        "name_prefix": "Mrs.",
        "credential": "PHD, DNP, MSHI, MPH,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11031671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Christine Ivelevitch, LCSW, LSW, LMSW
• Ivy Bridge Counseling, Inc.
• Iyer Sankaran M.D.P.a.
• Ashleigh Rose Jachles, RCSWI
• Lija Jacob, NP
• Kiana Nancy Jaime
• Angela Jaimes, ARNP
• Mohit Jain, MD
• James J. Hynick, D.O., P.a.
• James K Shea MD Inc

• Family Nurse Practitioner in Longwood, FL
• Providers in Longwood, 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 Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.