Active NPI
Meredith Leigh Shillinglaw, PA
- Physician Assistant
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-08162
- Practice address
- 3000 New Bern Ave
Raleigh, NC 27610-1231 - Phone
- (919) 350-7270
- NPI assigned
- Jun 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0008647 | CO | |
| Medical Physician Assistant | 363AM0700X | |||
| Physician Assistant | 363A00000X | 0010-08162 | NC | Primary |
Addresses
Primary practice location
3000 New Bern Ave
Raleigh, NC 27610-1231
Mailing address
105 Edgepine Dr
Holly Springs, NC 27540-9454
Phone (919) 418-8391
Other practice location 1
2500 Rocky Mountain Ave Ste 360
Loveland, CO 80538-9004
Phone (970) 221-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Wake Forest University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 Rocky Mountain Ave
Loveland, CO 80538-9004
4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260
Hospital & facility affiliations
- Medical Center of the Rockies
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.0008647 | CO | MD | Physician Assistant |
| 0010-08162 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients |
Locations
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
2500 Rocky Mountain Ave
Ste 360
Loveland, CO 80538
Phone (970) 221-5878
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412
2500 Rocky Mountain Ave
#360
Loveland, CO 80538
Interoperability endpoints
- mshillinglaw74791@directhisp.wakemed.org
Organizations & group practices 2
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.
-
- General Practice Physician
- Loveland, CO
- NPI 1225356868
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Greeley, CO
- NPI 1104262286
-
- General Acute Care Hospital
- Loveland, CO
- NPI 1750392304
-
- General Acute Care Hospital
- Greeley, CO
- NPI 1780243055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1043703523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 EDGEPINE DR",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275409454",
"telephone_number": "919-418-8391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101231",
"telephone_number": "919-350-7270"
}
],
"practiceLocations": [
{
"address_1": "2500 Rocky Mountain Ave Ste 360",
"address_purpose": "LOCATION",
"city": "Loveland",
"state": "CO",
"postal_code": "805389004",
"country_code": "US",
"telephone_number": "970-221-1000",
"fax_number": "970-624-1892",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHILLINGLAW",
"first_name": "MEREDITH",
"middle_name": "LEIGH",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0008647",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-08162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.