Individual provider Active NPI

Shelby Lynne Ransdell Sookdeo, PA-C

  • Physician Assistant
  • Clermont, FL
National Provider Identifier
1972059038
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9116652 Issued in FL
Practice address
1615 E State Highway 50
Suite 200
Clermont, FL 34711
Phone
(352) 404-4463
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9116652 FL Primary
Physician Assistant 363A00000X PA0004370 CO

Addresses

Primary practice location

1615 E State Highway 50
Suite 200
Clermont, FL 34711

Mailing address

135 Blackstone Creek Rd
Groveland, FL 34736-3622
Phone (719) 205-5549

Other identifiers 3

IdentifierTypeStateIssuer
PA9116652OtherFLFLORIDA LICENSE
15907394OtherCAQH
1099163OtherNCCPA CERTIFICATION

Other names 1

  • Shelby Lynne Ransdell Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230925001870 FL Practitioner - Physician Assistant 8921452996 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carespot of Orlando Hsi Urgent Care LLCGroup PAC ID 8921372558, 55 clinicians

Practice addresses (Care Compare)

1615 E Hwy 50
Suite 200
Clermont, FL 34711-5124
Phone (352) 404-4463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0004370COMDPhysician Assistant
9116652FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Solantic of Jacksonville, LLC PastSince Sep 5, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1972059038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BLACKSTONE CREEK RD",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347363622",
            "telephone_number": "719-205-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 E STATE HIGHWAY 50",
            "address_2": "SUITE 200",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "352-404-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOKDEO",
        "first_name": "SHELBY",
        "middle_name": "LYNNE RANSDELL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9116652",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0004370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "PA9116652",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15907394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION",
            "identifier": "1099163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "RANSDELL",
            "middle_name": "LYNNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.