Shannon Holland, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

85000977 Issued in IL

Practice address

810 Biesterfield Rd
Eberle Building, Suite 605
Elk Grove Village, IL 60007-7312

Phone

(847) 364-6724

Fax

(847) 364-6720

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
• Baylor Institute for Rehabilitation at Frisco Inpatient rehabilitation facility, Frisco, TX, CCN 673046
• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sholdren457232@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1124809512
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

• Baylor Regional Medical Center at Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Frisco, TX
  • NPI 1285930891

  Inpatient rehabilitation facility

  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1295762821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 SHANDREW DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408223",
            "telephone_number": "630-357-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 BIESTERFIELD RD",
            "address_2": "EBERLE BUILDING, SUITE 605",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077312",
            "telephone_number": "847-364-6724",
            "fax_number": "847-364-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "85000977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sholdren457232@direct.sw.org",
            "affiliation": "N",
            "address_1": "925 E Southlake Blvd Ste 100",
            "city": "Southlake",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760921477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lorraine K. Hippner, FNP-BC
• Hiroshi Ueno DDS Ms PLLC
• Alison Hogan, OTRL
• Hollie D Holbach, PT
• Karen Holcombe
• Aaron Homan, B.A.
• Joshua David Homan, BSN
• Brian Homann, D.D.S.
• Home Sweet Home Supportive Living LLC
• Homer Glen Medical Services Corp

• Medical Physician Assistant in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.