SHANNON CAMPBELL NP
NPI 1780050419
Nurse Practitioner in Jacksonville, FL

Q: What is Shannon Campbell's NPI number?

The NPI number for Shannon Campbell is 1780050419. It was assigned to this individual provider in the NPPES registry on August 17, 2015.

Q: What is Shannon Campbell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Campbell was last updated on August 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since August 17, 2015PECOS EnrolledAccepts Medicare Assignment

76.2/100

CMS Quality Rating

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: August 4, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 4, 2021, Mar 9, 2021, Mar 17, 2018 and 2 more (5 updates tracked since 2016).

On this page

About Shannon Campbell Np NPPES

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

SHANNON CAMPBELL NP (NPI 1780050419) is an individual nurse practitioner in Jacksonville, Florida, licensed in Florida (APRN11013387) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1780050419

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSHANNON CAMPBELLCredential: NP

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000

Phone(904) 953-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateAugust 17, 2015

Last NPPES UpdateAugust 4, 20215 updates tracked since enumeration

NPPES CertifiedAugust 4, 2021

✔ NPI 1780050419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · APRN11013387

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 026.0103043 (VT)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 101.0120646 (VT)

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Campbell Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860739034

PECOS Enrollment IDI20211022001634, I20211217002114, I20211221001649

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic

Acute Care Hospitals · Jacksonville, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100151

Location4500 San Pablo RdJacksonville, FL 32224 · Duval County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.2/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

69.33

Promoting Interoperability

100

Improvement Activities

Cost

51.32

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE L WALSH PA-C/MPH

Physician Assistant