SHENANDOAH MEDICAL CARE CENTER
NPI 1417494154
Clinic/Center - Primary Care in Lantana, FL
About Shenandoah Medical Care Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHENANDOAH MEDICAL CARE CENTER (NPI 1417494154) is a healthcare organization registered as a primary care in Lantana, Florida and active in the NPI registry since January 2017. The organization lists Joy L Fuller, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shenandoah Medical Care Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Shenandoah Medical Care Center, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 10D2121346
Shenandoah Medical Care Center LLC · Lantana, FLFrequently 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 Shenandoah Medical Care Center's NPI number?
The NPI number for Shenandoah Medical Care Center is 1417494154. It was assigned to this organization in the NPPES registry on January 19, 2017.
Where is Shenandoah Medical Care Center located?
Shenandoah Medical Care Center is located at 6234 S Congress Ave Suite F-1, Lantana, FL 33462. The listed phone number is (561) 619-9510.
What is Shenandoah Medical Care Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Shenandoah Medical Care Center enrolled in Medicare?
Yes. Shenandoah Medical Care Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shenandoah Medical Care Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Shenandoah Medical Care Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Shenandoah Medical Care Center was last updated on January 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Shenandoah Medical Care Center · NPI 1417494154
Primary Care organization in Lantana, Florida. Organization record, active in the CMS NPPES registry since January 19, 2017.
## Identity
- **NPI:** 1417494154 (Entity type: Organization)
- **Enumerated:** January 19, 2017
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Joy Fuller, OWNER
## Practice location
- **Address:** 6234 S CONGRESS AVE, SUITE F-1, Lantana, FL 33462-2307
- **Phone:** (561) 619-9510
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 19, 2017
- **Other identifiers:** Medicare UPIN CE016Z (FL); Medicaid 010866400 (FL)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1417494154) · Data from the CMS NPPES public registry.