Individual provider Active NPI

Shannon Dawn Zundel, PA-C

  • Physician Assistant
  • Dalton, GA
National Provider Identifier
1356665509
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005735 Issued in GA
Practice address
1413 Chattanooga Ave
Dalton, GA 30720-2631
Phone
(706) 279-2635
Fax
(706) 279-2679
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005735 GA Primary

Addresses

Primary practice location

1413 Chattanooga Ave
Dalton, GA 30720-2631

Mailing address

1413 Chattanooga Ave
Dalton, GA 30720-2631
Phone (706) 279-2635

Other practice location 1

715 Queen City Pkwy Ste 106
Gainesville, GA 30501-4335
Phone (678) 450-1222

Other identifiers 6

IdentifierTypeStateIssuer
003141153DMedicaidGA
003141153EMedicaidGA
003141153HMedicaidGA
003141153JMedicaidGA
003141153FMedicaidGA
003141153GMedicaidGA

Other names 1

  • Shannon Dawn Osborne Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20150107000238 GA Practitioner - Physician Assistant 3779806344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1413 Chattanooga Ave
Dalton, GA 30720-2631
Phone (706) 279-2635

1940 Parker CT
Suite B
Stone Mountain, GA 30087-3456
Phone (706) 279-2635

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Promoting interoperability
96
Improvement activities
40
Cost
81.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005735GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Spine & Pain Medicine PC CurrentSince Mar 11, 2018 Accepting new patients
Center for Spine & Pain Medicine, PC Current Accepting new patients
Georgia Pain Physicians PC Physician Assistant Past Accepting new patients

Locations

185 Professional Ct SE
Calhoun, GA 30701
Phone (706) 279-2635

1413 Chattanooga Ave
Dalton, GA 30720
Phone (706) 279-2635

715 Queen City Pkwy
Ste 106
Gainesville, GA 30501
Phone (678) 450-1222

1940 Parker Ct
Ste B
Stone Mountain, GA 30087
Phone (706) 279-2635

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECFEAA/Endpoint/ECFEAA

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1356665509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 CHATTANOOGA AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202631",
            "telephone_number": "706-279-2635",
            "fax_number": "706-279-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 CHATTANOOGA AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202631",
            "telephone_number": "706-279-2635",
            "fax_number": "706-279-2679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Queen City Pkwy Ste 106",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305014335",
            "country_code": "US",
            "telephone_number": "678-450-1222",
            "fax_number": "706-279-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZUNDEL",
        "first_name": "SHANNON",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141153D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141153E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141153H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141153J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141153F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141153G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "OSBORNE",
            "middle_name": "DAWN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.