Individual provider Active NPI

Shannon Mary Carres, PA-C

  • Psychiatry Physician
  • Marlton, NJ
National Provider Identifier
1225604176
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9117419 Issued in FL
Practice address
5 Greentree Center
Suite 117
Marlton, NJ 08053-3422
Phone
(609) 484-0106
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9114719 FL
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 9117419 FL Primary

Addresses

Primary practice location

5 Greentree Center
Suite 117
Marlton, NJ 08053-3422

Mailing address

3100 17TH St Ste a
Saint Cloud, FL 34769-6021
Phone (407) 892-0009

Other practice location 1

3100 17th St Ste A
Saint Cloud, FL 34769-6021
Phone (407) 892-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, NJ, OH, NC5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20210903000420 FL Practitioner - Physician Assistant 4789080458 Reassigns benefits to 3 organizations
I20230124000342 GA Practitioner - Physician Assistant 4789080458 Reassigns benefits to 2 organizations
I20230922000646 NJ Practitioner - Physician Assistant 4789080458 Reassigns benefits to 1 organization
I20251015001390 OH Practitioner - Physician Assistant 4789080458 Reassigns benefits to 1 organization
I20260527000255 NC Practitioner - Physician Assistant 4789080458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriving LaneGroup PAC ID 1355741083, 24 clinicians
Workit Health Mi PLLCGroup PAC ID 6406101625, 22 clinicians
Workit Health NJ LLCGroup PAC ID 8325477904, 8 clinicians

Practice addresses (Care Compare)

2801 Buford Hwy NE
Suite T10
Atlanta, GA 30329-2149
Phone (347) 830-7720

3719 Latrobe Dr
Suite 850M
Charlotte, NC 28211-4827
Phone (704) 686-7572

525 Route 73 N
Suite 117
Marlton, NJ 08053-3422
Phone (609) 474-0106

600 Heritage Dr
Suite 200
Jupiter, FL 33458-3097
Phone (954) 231-3080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9117419FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Workit Health Mi PLLC CurrentSince Dec 31, 2021 Accepting new patients
Workit Health (Oh) LLC CurrentSince Oct 3, 2025 Accepting new patients
Workit Health Mi PLLC CurrentSince Dec 31, 2021 Accepting new patients
Workit Health Mi PLLC CurrentSince Jan 11, 2023 Accepting new patients

Locations

600 Heritage Dr
Ste 200
Jupiter, FL 33458
Phone (561) 354-1525

3300 Washtenaw Ave
Ste 280
Ann Arbor, MI 48104
Phone (734) 329-5419

3719 Latrobe Dr
Ste 850M
Charlotte, NC 28211
Phone (704) 686-7572

6855 Spring Valley Dr
Ste 110
Holland, OH 43528
Phone (216) 438-0283

Interoperability endpoints

  • Direct secure messaging: thrivinglanellc.shannoncarres@149897.advancedmd-direct.com
  • Direct secure messaging: shannon.carres@597174495543300.direct.elationemr.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1225604176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 17TH ST STE A",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696021",
            "telephone_number": "407-892-0009",
            "fax_number": "407-892-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GREENTREE CENTER",
            "address_2": "SUITE 117",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533422",
            "telephone_number": "609-484-0106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 17th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347696021",
            "country_code": "US",
            "telephone_number": "407-892-0009",
            "fax_number": "407-892-3285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRES",
        "first_name": "SHANNON",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9114719",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "9117419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.