NPIMap

Individual provider Active NPI

Shannon Wheaton, PA-CERTIFIED

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1225599657
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0007247 Issued in CO
Practice address
2100 E Ocean View Ave Apt 37
Norfolk, VA 23518-6103
Phone
(678) 755-6308
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 0007247 CO Primary

Addresses

Primary practice location

2100 E Ocean View Ave Apt 37
Norfolk, VA 23518-6103

Mailing address

2100 E Ocean View Ave Apt 37
Norfolk, VA 23518-6103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191030000993 VA Practitioner - Physician Assistant 1759613458 Reassigns benefits to 1 organization
I20220324000184 CO Practitioner - Physician Assistant 1759613458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

1818 N Ogden St
Suite 400
Denver, CO 80218-1280
Phone (303) 318-2460

300 Exempla Cir
310 Imh Heart and Vascular Institute Lafayatt
Lafayette, CO 80026-3394
Phone (303) 272-0500

300 Exempla Cir
Suite 360 Im Heart and Vascular 360 Lafayet
Lafayette, CO 80026-3395
Phone (303) 272-0500

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Denver, CO, CCN 060028
  • Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116
  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0007247COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Platte Valley Medical Group LLC Multi-Specialty CurrentSince May 30, 2022 Accepting new patients
Sentara Medical Group Multi-Specialty CurrentSince Oct 25, 2019 Accepting new patients
Intermountain Medical Group Denver, LLC Multi-Specialty CurrentSince Mar 11, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Multi-Specialty CurrentSince Mar 11, 2022 Accepting new patients
Platte Valley Medical Group, LLC Multi-Specialty CurrentSince May 30, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Multi-Specialty Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1818 N Ogden St
Ste 400
Denver, CO 80218
Phone (303) 318-2440

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

300 Exempla Cir
Ste 310
Lafayette, CO 80026
Phone (303) 272-0500

1031 Loftis Blvd
Ste 100
Newport News, VA 23606
Phone (757) 736-9860

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Interoperability endpoints

  • Direct secure messaging: swheaton418770@direct.sentara.net

Organizations & group practices 6

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 10

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1225599657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E OCEAN VIEW AVE APT 37",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235186103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E OCEAN VIEW AVE APT 37",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235186103",
            "telephone_number": "678-755-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATON",
        "first_name": "SHANNON",
        "credential": "PA-CERTIFIED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0007247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.