Active NPI
Shannon Marcus Jude Quamina, PA
- Physician Assistant
- Tampa, FL
National Provider Identifier
1144766452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9111115
- Practice address
- 13000 Bruce B Downs Blvd
Tampa, FL 33612-4745 - Phone
- (813) 972-2000
- NPI assigned
- Jan 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-06916 | NC | |
| Physician Assistant | 363A00000X | PA9111115 | FL | Primary |
Addresses
Primary practice location
13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Mailing address
13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Phone (813) 972-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1144766452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13000 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124745",
"telephone_number": "813-972-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13000 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124745",
"telephone_number": "813-972-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUAMINA",
"first_name": "SHANNON",
"middle_name": "MARCUS JUDE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-10",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-06916",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9111115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.