SHORES MEDICAL CENTER
NPI 1114111440
Family Medicine in Daytona Beach Shores, FL
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
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
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, FLOther Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DAYTONA BEACH SHORES, FL 32118
DAYTONA BEACH SHORES, FL 32118
DAYTONA BEACH SHORES, FL 32118
DAYTONA BEACH SHORES, FL 32118
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.
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 18 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.
# Shores Medical Center · NPI 1114111440
Family Medicine organization in Daytona Beach Shores, Florida. Organization record, active in the CMS NPPES registry since August 29, 2007.
## Identity
- **NPI:** 1114111440 (Entity type: Organization)
- **Enumerated:** August 29, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Gerald R Woodard Do Pa
- **Organization subpart:** No
- **Authorized official:** Gerald Woodard, PRESIDENT
## Practice location
- **Address:** 3512 S ATLANTIC AVE, Daytona Beach Shores, FL 32118-7639
- **Phone:** (386) 767-9544 · **Fax:** (386) 756-0501
## Record status
- **NPPES last updated:** August 29, 2007
- **Other identifiers:** Medicare PIN K6813 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114111440) · Data from the CMS NPPES public registry.