Shannon Elizabeth Hamilton, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2011011827 Issued in MO

Practice address

409 Lafayette Ctr
Manchester, MO 63011-3943

Phone

(636) 707-0764

NPI assigned

May 2, 2011

Last updated

Oct 12, 2022By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment
• Mercy East Ambulatory Services LLC

  dba Mercy-GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Chesterfield, MO
  • NPI 1134673148
  Medicare reassignment
• SLH Physicians LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1881668051
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Bridgeton, MO
  • NPI 1851946370
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Coastal Wound Physicians

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Savannah, GA
  • NPI 1508007774
  NPD (past)

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1164713632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 LAFAYETTE CTR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630113943",
            "telephone_number": "636-707-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 LAFAYETTE CTR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630113943",
            "telephone_number": "636-707-0764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 N Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312329",
            "country_code": "US",
            "telephone_number": "314-996-5225",
            "fax_number": "314-991-0943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2011011827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rieko T Griffin, LCSW
• Guarantee Medical Supply Company LLC
• Emily Haffner, MS,RD,LD,CDE
• Avery Hagedorn, PHARMD
• Thomas H Hale, MD
• Susan Irene Hanlon
• Stetson Hanning, PTA
• Cathleen Hardin, RN
• Stephen Edward Haring, O.D.
• Fizza Hassan, PA

• Physician Assistant in Manchester, MO
• Providers in Manchester, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.