Shannah Riley Wayne

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5115 Oleander Dr
Wilmington, NC 28403-7018

Phone

(910) 362-1011

NPI assigned

Jan 25, 2021

Last updated

Jun 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swayne66971@direct.utmb.edu

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.

• Wilmington Gastroenterology Associates,PA

  • Gastroenterology Physician
  • Wilmington, NC
  • NPI 1922040419

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1265022180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6586 WILLOWBANK PL SW",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284697323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284037018",
            "telephone_number": "910-362-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "SHANNAH",
        "middle_name": "RILEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "0010-11948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa McIntosh Watson, FNP
• Noah F Watson, LCMHCA, LCASA
• Samantha Watson, M.D.
• Starr Benson Watson, PTA
• Linda M Watts, CRNA
• David Allen Weatherford, M.D.
• Marsha Weatherly
• Thomas Anthony Weathers, LCAS/LCSW
• Jonna Weathington, MSW, LCSW-A
• Andrew Wilson Weaver, FNP

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, 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 Jun 16, 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.
• 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.