SHAWNDOLYN BRUTEN
NPI 1629685060
Nurse Practitioner - Family in Daytona Beach, FL
About Shawndolyn Bruten NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAWNDOLYN BRUTEN (NPI 1629685060) is an individual family provider in Daytona Beach, Florida, licensed in Florida (APRN11008739) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shawndolyn Bruten is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Shawndolyn Bruten reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Orlando, FL 32819
- Reassigned Medicare billing, Florida enrollment
- 208 clinicians in this Medicare group
Nashville, TN 37219
- Reassigned Medicare billing, Florida enrollment
- 85 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DAYTONA BEACH, FL 32114
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 Shawndolyn Bruten's NPI number?
The NPI number for Shawndolyn Bruten is 1629685060. It was assigned to this individual provider in the NPPES registry on September 29, 2020.
Where is Shawndolyn Bruten located?
Shawndolyn Bruten practices at 325 S Segrave St, Daytona Beach, FL 32114. The listed phone number is (386) 868-6180.
What is Shawndolyn Bruten's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shawndolyn Bruten enrolled in Medicare?
Yes. Shawndolyn Bruten is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Shawndolyn Bruten's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shawndolyn Bruten reassigns Medicare benefits to 2 organizations: Wound Technology Network Inc (Orlando, FL) and Community Care Health Network LLC (Nashville, TN). Each 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 Shawndolyn Bruten's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shawndolyn Bruten was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Shawndolyn Bruten · NPI 1629685060
Family physician in Daytona Beach, Florida. Individual provider, active in the CMS NPPES registry since September 29, 2020.
## Identity
- **NPI:** 1629685060 (Entity type: Individual)
- **Enumerated:** September 29, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** APRN11008739 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 325 S SEGRAVE ST, Daytona Beach, FL 32114-4815
- **Phone:** (386) 868-6180
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Wound Technology Network Inc (NPI 1962601393, Orlando, FL); Community Care Health Network LLC (NPI 1619368842, Nashville, TN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 29, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1629685060) · Data from the CMS NPPES public registry.