Individual provider Active NPI

Shawnna Lee Patterson, M.D., PH.D.

  • Neurology Physician
  • Rockledge, FL
National Provider Identifier
1205899820
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME98712 Issued in FL
Practice address
211 Coral Sands Dr Ste B
Rockledge, FL 32955-2749
Phone
(321) 345-6331
Fax
(213) 453-2953
NPI assigned
Apr 7, 2006
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2009-01845 NC
Neurology Physician 2084N0400X ME98712 FL Primary

Addresses

Primary practice location

211 Coral Sands Dr Ste B
Rockledge, FL 32955-2749

Mailing address

211 Coral Sands Dr Ste B
Rockledge, FL 32955-2749
Phone (321) 345-6331

Other identifiers 2

IdentifierTypeStateIssuer
278017800MedicaidFL
5913017MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071107000184 FL Practitioner - Neurology 9638266646 Reassigns benefits to 1 organization
I20100125000166 NC Practitioner - Neurology 9638266646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Iowa, RJ & L Carver College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knight Neurology LLCGroup PAC ID 5698916344, 8 clinicians

Practice addresses (Care Compare)

211 Coral Sands Dr
Suite B
Rockledge, FL 32955-2748

211 Coral Sands Dr
Suite B
Rockledge, FL 32955-2749
Phone (321) 345-6331

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.68 of 100Reported as group
Quality
62.02
Improvement activities
40
Cost
76.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ME98712FLMDNeurology Physician
2009-01845NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jun 1, 2011 Accepting new patients
Knight Neurology LLC CurrentSince Aug 15, 2017 Accepting new patients
Brain and Spine LLC Neurology PastSince Jun 1, 2010 Accepting new patients

Locations

1978 US Highway 1
Ste 103
Rockledge, FL 32955
Phone (321) 508-0999

211 Coral Sands Dr
Ste B
Rockledge, FL 32955
Phone (321) 345-6331

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2280 Hemby Ln
Greenville, NC 27834
Phone (252) 744-9400

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0000070
  • Direct secure messaging: spatterson71816@epicdirect.hf.org

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

Hospital & facility affiliations 7

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1205899820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CORAL SANDS DR STE B",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552749",
            "telephone_number": "321-345-6331",
            "fax_number": "321-345-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CORAL SANDS DR STE B",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552749",
            "telephone_number": "321-345-6331",
            "fax_number": "213-453-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "SHAWNNA",
        "middle_name": "LEE",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2009-01845",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME98712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278017800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913017",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.