Shawna Renee Carbonniere, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3516 Issued in AZ

Practice address

3110 Clearwater Dr Ste B
Prescott, AZ 86305-7177

Phone

(623) 516-8252

Fax

(623) 516-8253

NPI assigned

Mar 20, 2007

Last updated

May 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shawna Renee Gomez Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16465/brand/1/csg/1/fhir/r4
• Direct secure messaging: shawna.carbonnierepac.p1@direct.nextcare.nextgenshare.com

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.

• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  Medicare reassignment Care Compare group
• Arizona Arthritis & Rheumatology Associates P C

  • Rheumatology Physician
  • Phoenix, AZ
  • NPI 1366489254
  Medicare reassignment NPD
• Black Canyon Community Health Center, Inc.

  • Family Medicine Physician
  • Black Canyon City, AZ
  • NPI 1679723217
  Medicare reassignment NPD
• Novaspine Pain Institute, PLC

  • Pain Medicine Physician
  • Sun City West, AZ
  • NPI 1154745263
  Medicare reassignment NPD
• Nextcare Arizona LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment
• Arizona Arthritis and Rheumatology Associates

  • Rheumatology Physician
  • Glendale, AZ
  • NPI 1447730023
  NPD
• Black Canyon Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mayer, AZ
  • NPI 1124730627
  NPD
• Novaspine Pain Institute, PLC

  • Pain Medicine Physician
  • Sun City West, AZ
  • NPI 1265233019
  NPD
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1649554940
  NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1265557060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5281 N 99TH AVE STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853052209",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 CLEARWATER DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057177",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONNIERE",
        "first_name": "SHAWNA",
        "middle_name": "RENEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "GOMEZ",
            "middle_name": "RENEE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Quinn Cannon
• Stephen A Cantor, M.D.
• Canyon Mobile Srvices, LLC
• Zoraida Capllonch
• Daniel E Capps, LCSW
• Cardio Sleep Solutions Arizona LLC
• Care Planning Institute
• Care Planning Institute, Inc
• Juliana Mary Cargill, ANP GNP
• Caring Presence in Home Care LLC

• Medical Physician Assistant in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.