SHENANDOAH MEDICAL CARE CENTER
NPI 1417494154
Clinic/Center - Primary Care in Lantana, FL

Active since January 19, 2017CLIA 10D2121346 · Waiver
6234 S CONGRESS AVE, SUITE F-1, LANTANA, FL 33462(561) 619-9510 Get Directions Write a Review

NPPES record last updated: January 19, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Clinic/Center
  • Primary Care
  • CLIA Number: 10D2121346
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 11-02-2026

About SHENANDOAH MEDICAL CARE CENTER

This page provides the complete NPI Profile along with additional information for Shenandoah Medical Care Center, a primary care provider established in Lantana, Florida operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1417494154 assigned on January 2017. The practitioner's primary taxonomy code is 261QP2300X with license number 2602122 (). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Miss Joy L Fuller Arnp (Owner)

NPI
1417494154 Verify this NPI
Provider Name
SHENANDOAH MEDICAL CARE CENTER
Entity Type
Organization
Location Address
6234 S CONGRESS AVE SUITE F-1 LANTANA, FL 33462
Location Phone
(561) 619-9510
Mailing Address
PO BOX 741424 BOYNTON BEACH, FL 33474
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-19-2017
Last Update Date
01-19-2017
Code Navigator

A primary care provider (PCP) like Shenandoah Medical Care Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities
License No.
2602122

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MISS JOY L FULLER ARNP

Authorized Official Title
OWNER
Authorized Official Phone
(561) 853-7233

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
CE016ZMEDICARE UPIN (02)FL 
010866400MEDICAID (05)FL 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2121346
Facility Type
Practitioner Other
Certificate Effective Date
November 03, 2024
Certificate Expiration Date
November 02, 2026
Laboratory Director
JOY L. FULLER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Shenandoah Medical Care Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for SHENANDOAH MEDICAL CARE CENTER

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center
6234 S CONGRESS AVE, SUITE F1
LANTANA, FL 33462

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417494154, enumerated as an "organization" on January 19, 2017.

The provider is located at 6234 S CONGRESS AVE SUITE F-1 LANTANA, FL 33462 and the phone number is (561) 619-9510.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.