Shelly Ann Foltz, CRNA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

ARNP1796622 Issued in FL

Practice address

418 Royal Tern Rd S
Ponte Vedra Beach, FL 32082-7222

Phone

(904) 501-8985

NPI assigned

Jan 18, 2006

Sex

Female

Sole proprietor

Yes

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

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Florida Institute of Pain Medicine LLC

  • Interventional Pain Medicine Physician
  • Jacksonville, FL
  • NPI 1194056283
  Medicare reassignment NPD
• Northern Florida Anesthesia Services PLLC

  • Anesthesiology Physician
  • Jacksonville, FL
  • NPI 1033691050
  Medicare reassignment NPD
• Riverside Anesthesia Services, LLC

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
  • NPI 1134478209

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Florida Institute of Pain Medicine LLC

  • Interventional Pain Medicine Physician
  • Palm Coast, FL
  • NPI 1144913666
  NPD
• North Florida Anesthesia Consultants, Inc.

  • Anesthesiology Physician
  • St Augustine, FL
  • NPI 1114892361
  NPD (past)
• Sunbelt Visiting Primary Care LLC

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1598278707
  NPD (past)
• Ambulatory Anesthesia Services, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Wilmington, NC
  • NPI 1790816254
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1962482794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 ROYAL TERN RD S",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827222",
            "telephone_number": "904-501-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 ROYAL TERN RD S",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827222",
            "telephone_number": "904-501-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLTZ",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 1796622",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "ARNP1796622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiologist Assistant in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Anesthesiologist Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.