Individual provider Active NPI

Shelley Rose Perry, APRN

  • Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1982830618
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN1113732 Issued in FL
Practice address
4241 NW American LN
Lake City, FL 32055-4881
Phone
(386) 752-2246
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN1113732 FL Primary

Addresses

Primary practice location

4241 NW American LN
Lake City, FL 32055-4881

Mailing address

327 NW Hackney Ter
Lake City, FL 32055-3173
Phone (305) 342-7845

Other practice location 1

1116 11th St SW
Live Oak, FL 32064-3608
Phone (386) 362-0820

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
I20140820000996 FL Practitioner - Nurse Practitioner 1153549985 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baya Urgent Care LLCGroup PAC ID 7911124102, 9 clinicians
Merk, IncGroup PAC ID 1951340397, 6 clinicians

Practice addresses (Care Compare)

1465 W US Hwy 90
Suite 100
Lake City, FL 32055-6154
Phone (386) 755-2268

404 NW Hall of Fame Dr
Lake City, FL 32055-4833
Phone (386) 754-3627

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN1113732FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Urgent Care Center CurrentSince Jun 16, 2014 Accepting new patients
Nahed S. Sobhy M.D. P.a. Current Accepting new patients
Baya Urgent Care LLC CurrentSince Jul 26, 2016 Accepting new patients
Merk, Inc CurrentSince Feb 22, 2025 Accepting new patients
South Florida International Cardiology Consultants Inc Past Accepting new patients

Locations

2786 W US Highway 90
Ste 105
Lake City, FL 32055
Phone (386) 758-2944

404 NW Hall of Fame Dr
Lake City, FL 32055
Phone (386) 719-2540

1465 W US Highway 90
Ste 100
Lake City, FL 32055
Phone (386) 755-2268

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1982830618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 NW HACKNEY TER",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553173",
            "telephone_number": "305-342-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 NW AMERICAN LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554881",
            "telephone_number": "386-752-2246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 11th St SW",
            "address_purpose": "LOCATION",
            "city": "Live Oak",
            "state": "FL",
            "postal_code": "320643608",
            "country_code": "US",
            "telephone_number": "386-362-0820",
            "fax_number": "386-438-8629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "SHELLEY",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN1113732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.