Shannon Watkins, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

7230 Issued in AZ

Practice address

370 E Virginia Ave Ste 100
Phoenix, AZ 85004-1254

Phone

(602) 258-4788

NPI assigned

Sep 17, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shannon Leipus Former name

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Center for Hand Surgery PCGroup PAC ID 4880585603, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arizona Center for Hand Surgery PC

  • Surgery of the Hand (Surgery) Physician
  • Phoenix, AZ
  • NPI 1972502227
  Medicare reassignment Care Compare group NPD
• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• Arizona Center for Hand Surgery PC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1467284828
  NPD
• Arizona Center for Hand Surgery PC

  • Durable Medical Equipment & Medical Supplies
  • Scottsdale, AZ
  • NPI 1609588235
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1013491968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20808 N 27TH AVE APT 2030",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E VIRGINIA AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041254",
            "telephone_number": "602-258-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "7230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "LEIPUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Anne Watkins, LPC
• Lynn Watkins, RN
• Marley Wayne Watkins, PH.D.
• Olivia Raveen Watkins, ND
• Ronald H. Watkins, DDS
• Timothy Neil Watkins, R,.N.
• Wanda Watkins, LPN
• William David Watkins, RPH
• Micaela Watmore
• Trey Watmore, PA-C

• Surgical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.