Individual provider Active NPI

Shannon Lee Smith, PA

  • Physician Assistant
  • Arvada, CO
National Provider Identifier
1114799202
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10280 W 55TH Ave
Arvada, CO 80002-4925
Phone
(303) 914-6011
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CO Primary

Addresses

Primary practice location

10280 W 55TH Ave
Arvada, CO 80002-4925

Mailing address

10280 W 55TH Ave
Arvada, CO 80002-4925
Phone (303) 914-6011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240627002555 WA Practitioner - Physician Assistant 1951845262 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kirkpatrick Family Care, PSGroup PAC ID 3375536436, 13 clinicians
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

1706 Washington Way
Longview, WA 98632-2952
Phone (360) 423-9580

80 SW 2ND St
Renton, WA 98057-5937
Phone (877) 883-9430

PO Box
Suite 1338
Longview, WA 98632-7785

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Altea Medical Washington PLLC CurrentSince Feb 11, 2026 Accepting new patients
Post Acute Medical PLLC CurrentSince Feb 11, 2026 Accepting new patients
Kirkpatrick Family Care, PS CurrentSince Apr 30, 2024 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

303 Telegraph Rd
Bellingham, WA 98226
Phone (360) 863-6696

1706 Washington Way
Longview, WA 98632
Phone (360) 423-9580

783 Commerce Ave
Ste 300
Longview, WA 98632
Phone (360) 200-4318

80 SW 2nd St
Renton, WA 98057
Phone (425) 226-4510

2821 S Walden St
Seattle, WA 98144
Phone (206) 577-6200

6025 N Assembly St
Spokane, WA 99205
Phone (509) 326-8282

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1114799202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10280 W 55TH AVE",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800024925",
            "telephone_number": "303-914-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10280 W 55TH AVE",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800024925",
            "telephone_number": "303-914-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.