SHANNON KELLY BEARDSLEY DNP, APRN, FNP-BC
NPI 1861172322
Nurse Practitioner - Family in Jacksonville, FL

Q: What is Shannon Beardsley's NPI number?

The NPI number for Shannon Beardsley is 1861172322. It was assigned to this individual provider in the NPPES registry on July 20, 2023. The provider is also known as Shannon Kelly Vail.

Q: What is Shannon Beardsley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Beardsley was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 July 20, 2023PECOS Enrolled

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

NPPES record last updated: August 11, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 11, 2026, Apr 18, 2026, Jul 20, 2023 (3 updates tracked since 2023).

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About Shannon Kelly Beardsley Dnp, Aprn, Fnp-bc NPPES

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

SHANNON KELLY BEARDSLEY DNP, APRN, FNP-BC (NPI 1861172322) is an individual family provider in Jacksonville, Florida, licensed in Florida (APRN11027431) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1861172322

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHANNON KELLY BEARDSLEYCredential: DNP, APRN, FNP-BC

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912

Phone(904) 953-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJuly 20, 2023

Last NPPES UpdateAugust 11, 20263 updates tracked since enumeration

NPPES CertifiedAugust 11, 2026

✔ NPI 1861172322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · APRN11027431

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Other Names 1

Former Name (1)Shannon Kelly Vail

Secondary Practice Location 1

Location 14266 Sunbeam RdJacksonville, FL 32257-2425 · Phone (904) 268-7700 · Fax (904) 407-6001

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Kelly Beardsley Dnp, Aprn, Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456715028

PECOS Enrollment IDI20230914003294

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.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Beardsley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mayo Clinic Jacksonville

Same address

Health Service

4500 SAN PABLO RD S
Jacksonville, FL 32224

Reassigned Medicare billing, Florida enrollment
1,828 clinicians in this Medicare group

NPI 1174143986 (904) 953-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100117

Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County

Emergency services Birthing friendly

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.

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