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SHORES MEDICAL CENTER
NPI 1114111440
Family Medicine in Daytona Beach Shores, FL

Active since August 29, 2007CLIA 10D0267882 · Waiver
3512 S ATLANTIC AVE, DAYTONA BEACH SHORES, FL 32118(386) 767-9544(386) 756-0501 Get Directions Write a Review

NPPES record last updated: August 29, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shores Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHORES MEDICAL CENTER (NPI 1114111440) is a healthcare organization registered as a family medicine in Daytona Beach Shores, Florida and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through June 20, 2028 and lists Gerald R Woodard, President, as its authorized official.

NPPES Registry Identity

NPI1114111440
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGERALD R WOODARD DO PA
Location Address3512 S ATLANTIC AVEDaytona Beach Shores, FL 32118-7639
Mailing Address3512 S Atlantic AveDaytona Beach Shores, FL 32118-7639 · (386) 767-9544 · Fax (386) 756-0501
Phone(386) 767-9544
Fax(386) 756-0501
Organization SubpartNo
Authorized OfficialGerald R WoodardPresident · (386) 767-9544
Enumeration DateAugust 29, 2007
✔ NPI 1114111440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · OS4717
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3512 S ATLANTIC AVE, Daytona Beach Shores, FL 32118
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Other Names 1

Doing Business AsShores Medical Center

Other Identifiers 1

Medicare PINK6813FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shores Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Shores Medical Center, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Nurse Practitioner7
Family Practice3

Clinicians, nearest first (10)

Lauren Girard, DO
Family Practice
NPI 1346690484
3512 S ATLANTIC AVE
Daytona Beach Shores, FL 32118
(386) 767-9544
✔ PECOS✔ Accepts MedicareSame address
Tara James, FNP
Nurse Practitioner
NPI 1518433804
3512 S ATLANTIC AVE
Daytona Beach Shores, FL 32118
(386) 767-9544
✔ PECOS✔ Accepts MedicareSame address
Gerald Woodard, D.O.
Family Practice
NPI 1700877388
3512 S ATLANTIC AVE
Daytona Beach Shores, FL 32118
(386) 767-9544
✔ PECOS✔ Accepts MedicareSame address
Diane Gellermann, ARNP
Nurse Practitioner
NPI 1265891816
4645 CLYDE MORRIS BLVD STE 408
Port Orange, FL 32129
(386) 295-6601
✔ PECOS3.6 mi
Holly Mulvey
Nurse Practitioner
NPI 1639534159
339 SAGEWOOD DR
Port Orange, FL 32127
(386) 290-1154
✔ PECOS✔ Accepts Medicare3.7 mi
Angela Campbell, NP-C
Nurse Practitioner
NPI 1811265572
58 BAY HARBOUR DR
Ponce Inlet, FL 32127
(386) 231-6300
✔ PECOS4.9 mi
Samuel Miller, M.D.
Family Practice
NPI 1508050873
303 N CLYDE MORRIS BLVD
Daytona Beach, FL 32114
(386) 226-4542
✔ PECOS✔ Accepts Medicare6.1 mi
Brittany Korell, NP
Nurse Practitioner
NPI 1396475018
1865 LPGA BLVD
Daytona Beach, FL 32117
(386) 255-4596
✔ PECOS✔ Accepts Medicare8.7 mi
Orjanette Cooper-Bryant, APRN
Nurse Practitioner
NPI 1013034388
26 N BEACH ST STE C
Ormond Beach, FL 32174
(386) 506-9994
✔ PECOS11 mi
Meagan Burgess, APRN, FNP-BC
Nurse Practitioner
NPI 1891261863
405 WAYMONT CT STE 101
Lake Mary, FL 32746
(407) 732-4627
✔ PECOS35 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0267882

Shores Medical Center · Daytona Beach, FL
Active · expires Jun 20, 2028
CLIA Number10D0267882
Laboratory TypePhysician Office
Certificate Effective DateJune 21, 2026
Certificate Expiration DateJune 20, 2028
Laboratory DirectorGerald R. Woodard
Laboratory Phone(386) 767-9544
Laboratory LocationShores Medical Center3512 South Atlantic Avenue, Daytona Beach, FL 32118
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gerald R Woodard Do PA's NPI number?

The NPI number for Gerald R Woodard Do PA is 1114111440. It was assigned to this organization in the NPPES registry on August 29, 2007. The provider is doing business as Shores Medical Center.

Where is Gerald R Woodard Do PA located?

Gerald R Woodard Do PA is located at 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118. The listed phone number is (386) 767-9544.

What is Gerald R Woodard Do PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gerald R Woodard Do PA enrolled in Medicare?

Yes. Gerald R Woodard Do PA is registered in the Medicare PECOS enrollment system.

Does Gerald R Woodard Do PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0267882) is associated with this NPI, valid through June 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Gerald R Woodard Do PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Gerald R Woodard Do PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gerald R Woodard Do PA was last updated on August 29, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.