Shannon Wilson Henslee, MPA, MSED, ATC, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10732 Issued in GA

Practice address

1305 Jennings Mill Rd Ste 110
Watkinsville, GA 30677-7241

Phone

(706) 613-5880

NPI assigned

Feb 24, 2006

Last updated

Jan 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Shannon Lea Wilson Former name

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Athens Specialty Care LLCGroup PAC ID 8820349772, 116 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Piedmont Athens Specialty Care LLC

  • Cardiovascular Disease Physician
  • Athens, GA
  • NPI 1184130627
  Medicare reassignment Care Compare group

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

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1396711834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 DRIFTSTONE CIR",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287049140",
            "telephone_number": "443-243-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD STE 110",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777241",
            "telephone_number": "706-613-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Biltmore Ave",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288014601",
            "country_code": "US",
            "telephone_number": "828-258-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSLEE",
        "first_name": "SHANNON",
        "middle_name": "WILSON",
        "credential": "MPA, MSED, ATC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2022-01-18",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003302",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03506",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "10732",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WILSON",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.