Stephanie Shannon Pascale, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5011367 Issued in NC

Practice address

4201 Lake Boone TRL Ste 200
Raleigh, NC 27607-7511

Phone

(919) 782-2152

Fax

(919) 782-7929

NPI assigned

Jan 23, 2019

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

• Stephanie Nicole Shannon Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Dermatology PAGroup PAC ID 7012971609, 52 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanies@aadermaffiliates.emadirect.md

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.

• Southern Dermatology, P.a.

  • Specialist
  • Raleigh, NC
  • NPI 1568415586
  Medicare reassignment Care Compare group NPD
• Raleigh Dermatology Associates PA

  • Dermatology Physician
  • Raleigh, NC
  • NPI 1285674952
  NPD (past)
• Anne Arundel Dermatology Affiliates PC

  • Dermatology Physician
  • Hunt Valley, MD
  • NPI 1083200794
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1396209326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "919-782-2152",
            "fax_number": "919-782-7929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Springfield Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276098532",
            "country_code": "US",
            "telephone_number": "919-876-3656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCALE",
        "first_name": "STEPHANIE",
        "middle_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SHANNON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anjeleigh Lonnette Partridge, FNP-C
• Antonia Susan Partusch, PMHNP-BC
• Naseem S Paruk, MD
• Parvez DDS & Associates, PLLC
• Vijay G Paryani, M.D.
• George Washington Paschal III, MD
• Jennifer Oppenheim Paschaloudis, MS, RD, LDN
• Sara Pascucci, MS, NCC, LPC
• Victor Anthony Pascucci, PT
• Nadia Hameed Pasha, MD

• Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.