Shannon Michelle Craven, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03058 Issued in NC

Practice address

5 Regional Cir Ste C
Pinehurst, NC 28374-9796

Phone

(910) 295-1761

Fax

(910) 295-2937

NPI assigned

Jul 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Shannon Michelle Craven Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cary Skin Center PAGroup PAC ID 1153418371, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cary Skin Center, PA

  • MOHS-Micrographic Surgery Physician
  • Cary, NC
  • NPI 1902869530
  Medicare reassignment Care Compare group
• Carolina Skin Care, PA

  • Dermatology Physician
  • Pinehurst, NC
  • NPI 1205999687
  NPD (past)
• Southern Dermatology, P.a.

  • Specialist
  • Raleigh, NC
  • NPI 1568415586
  NPD (past)
• Dermone Dermatology Associates of Virginia PC

  • Dermatopathology Physician
  • South Boston, VA
  • NPI 1033553862
  NPD (past)
• Pih Health Physicians

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1588829006
  NPD (past)

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1245518281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 REGIONAL CIR STE B&C",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749796",
            "telephone_number": "910-295-1761",
            "fax_number": "910-295-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 REGIONAL CIR STE C",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749796",
            "telephone_number": "910-295-1761",
            "fax_number": "910-295-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110005287",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scraven@directaddress.net",
            "affiliation": "N",
            "address_1": "5 Regional Cir Ste C",
            "city": "Pinehurst",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283749796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CRAVEN",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Crafter
• Jessica Lynne Crafton
• Amber Cranford
• Rebecca Huddleston Cranford, DNP, CRNA
• Stacey Craven-Gatling, LCSW
• Sylvia Linell Crawford
• Maire Creasey
• Crisisbridge Psychiatry PLLC
• Sara Hackney Criss, PT, DPT
• Tricia Croake, M.D.

• Physician Assistant in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.