Individual provider Active NPI

Shannon Lynn, MPAS, PA-C

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1124173737
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2006038819 Issued in MO
Practice address
4401 Wornall Rd
Peet Center #5368
Kansas City, MO 64111-3220
Phone
(816) 932-6183
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 2006038819 MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Peet Center #5368
Kansas City, MO 64111-3220

Mailing address

4910 W 71St Ter
Prairie Village, KS 66208-2325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20120426000624 MO Practitioner - Physician Assistant 1850553454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006038819MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Jan 1, 2018 Accepting new patients
Saint Lukes Physician Group Inc Physician Assistant CurrentSince Jan 1, 2018 Accepting new patients
Saint Lukes Physician Group II LLC Past Accepting new patients

Locations

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

4401 Wornall Rd
#5368
Kansas City, MO 64111
Phone (816) 932-6183

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 3

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1124173737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 W 71ST TER",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WORNALL RD",
            "address_2": "PEET CENTER #5368",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113220",
            "telephone_number": "816-932-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "SHANNON",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2006038819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.