SHAWN STEPHENS – Gerontology Nurse Practitioner, NPI 1104651603

SHAWN STEPHENS is a healthcare provider. based in Lake mary, Florida. specializing in NURSE PRACTITIONER. They hold a License No. 11035070 (FL). The NPI Number for SHAWN STEPHENS is 1104651603

Main info

Female
6 Years Of Experience
Name
SHAWN STEPHENS
NPI
1104651603
Phone
(407) 647-2346
Address
525 Technology Park Ste 109
Enumeration Date
4 September 2024
Last Update Date
3 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4076472346111
Graduation Year
2020 (6 years ago)
PAC ID
8426584467
Group Practice PAC ID
7517491160
Professional Enrollment ID
I20241213000647
Address ID
FL327467107LA525XXPARK302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness85
Years active:1State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for SHAWN STEPHENS

  • 525 Technology Park Ste 109

    Lake Mary, FL 327467107

    Phone: (407) 647-2346

    Type: Location

  • 5516 GREAT EGRET DR

    LEESBURG, FL 347482034

    Phone: (813) 503-1702

    Type: Mailing

  • 2906 17TH ST

    SAINT CLOUD, FL 347696006

    Phone: (407) 892-2135

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241213000647INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32746)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517491160View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Infectious DiseaseFL
Nurse PractitionerNY
Internal MedicineFL
Nurse PractitionerFL
Internal MedicineFL

Reviews

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Frequently asked questions

Can I verify SHAWN STEPHENS with an NPI only?
You can start verification with NPI 1104651603 for SHAWN STEPHENS, then check state licensing separately.
Does CMS list SHAWN STEPHENS as active?
Yes — SHAWN STEPHENS is active in the NPI listing used on this page.
What is SHAWN STEPHENS's specialty?
The listing groups SHAWN STEPHENS with Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does SHAWN STEPHENS serve?
SHAWN STEPHENS's listing highlights Lake Mary, Florida; more addresses can appear in NPPES.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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