Shavon Prentice, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3007023 Issued in KY

Practice address

5743 Preston Hwy
Louisville, KY 40219-1305

Phone

(502) 444-6008

Fax

(502) 586-7173

NPI assigned

Aug 19, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1649732603
  Medicare reassignment NPD
• Alignmed Partners, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  KY

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY

  Medicare reassignment NPD
• Sorelle Wellness LLC

  • Clinic/Center
  • Louisville, KY
  • NPI 1023979903
  NPD Authorized official
• Family Health Center Pharmacy

  • Clinic Pharmacy
  • Louisville, KY
  • NPI 1477506202
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1104879469
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1134172489
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205889540
  NPD
• HMPS Internal Medicine of West Louisville PLLC

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1689280216
  NPD
• Neighborhood NP LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1811489321
  NPD (past)
• Oak Street Health Physicians Group of South Carolina, LLC

  • Primary Care Clinic/Center
  • Greenville, SC
  • NPI 1023614914

  Family

  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1962782128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740012",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5743 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402191305",
            "telephone_number": "502-444-6008",
            "fax_number": "502-586-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "SHAVON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71003614A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100200290",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premise Health of West Virginia Medical Medical Corporation
• Premise Health of West Virginia Medical Medical Corporation
• Premise Health of West Virginia Medical, Medical Corporation
• Premise Health of West Virginia Medical, Medical Corporation
• Prencare of Kentucky, Inc
• Travis Jason Prentice
• Presbyterian Homes and Services of Kentucky, Inc
• Presbyterian Homes and Services of Kentucky, Inc
• Prescient Medicine Holdings, Inc.
• Prescott Plastic Surgery & Med Spa PLLC

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.