Shanna Killebrew, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA964 Issued in AL

Practice address

4370 W Main St
Dothan, AL 36305-1056

Phone

(334) 793-5000

Fax

(334) 615-8418

NPI assigned

May 23, 2014

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

Medicare fee-for-service enrollment

Enrolled in AL

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

University of Alabama School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wiregrass Clinic LLCGroup PAC ID 2860662491, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flowers Hospital Hospital, Dothan, AL, CCN 010055

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanna.killebrew.1@3326.direct.athenahealth.com

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.

• Wiregrass Clinic LLC

  • Neurological Surgery Physician
  • Dothan, AL
  • NPI 1558657890
  Medicare reassignment Care Compare group
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment
• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  Medicare reassignment
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Physician Assistant

  NPD
• Northern Alabama Physicians, LLP

  • Hospitalist Physician
  • Dothan, AL
  • NPI 1992178628
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Triad of Alabama LLC

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1295147288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6599",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363026599",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEBREW",
        "first_name": "SHANNA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imran Khalil, M.D
• Shazia Khan, M.D.
• Claud Khater
• Abdul Haseeb Khatri, MD
• Mohamad Ayman Khedari, MD
• Todd Killingsworth, AT
• Jamie Leigh Kilpatrick Morrow, DO
• Kim K Vann, LLC
• Kimberley N. Holley
• Kimberly Berry LPC LLC

• Physician Assistant in Dothan, AL
• Providers in Dothan, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.