Individual provider Active NPI

Shannon M Morris, P.A.

  • Physician Assistant
  • Norfolk, VA
National Provider Identifier
1366775470
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003093 Issued in VA
Practice address
6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone
(757) 354-2885
Fax
(757) 917-5141
NPI assigned
Sep 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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 0110003093 VA Primary

Addresses

Primary practice location

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933

Mailing address

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130528000448 VA Practitioner - Physician Assistant 5698913986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid Atlantic Long Term Specialty Care LLCGroup PAC ID 8921427162, 28 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110003093VAMDPhysician Assistant

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1366775470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.