Individual provider Active NPI

Shannon Delong, PA-C

  • Physician Assistant
  • Winter Garden, FL
National Provider Identifier
1497752679
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101942 Issued in FL
Practice address
2000 Fowler Grove Blvd FL 3
Winter Garden, FL 34787-5050
Phone
(407) 614-0528
Fax
(407) 614-0529
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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 PA9101942 FL Primary

Addresses

Primary practice location

2000 Fowler Grove Blvd FL 3
Winter Garden, FL 34787-5050

Mailing address

2000 Fowler Grove Blvd FL 3
Winter Garden, FL 34787-5050
Phone (407) 614-0528

Other identifiers 1

IdentifierTypeStateIssuer
291344500MedicaidFL

Other names 1

  • Shannon Cartmill Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060118000971 FL Practitioner - Physician Assistant 0345264263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

2200 Fowler Grove Blvd
Suite 140
Winter Garden, FL 34787-5597
Phone (407) 614-0528

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Apr 6, 2015 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 6, 2015 Accepting new patients
Central Florida Family Health Center, Inc. Past Accepting new patients
Great Lakes Bay Health Centers Past Accepting new patients
Central Florida Family Health Center Inc. Past Accepting new patients
Great Lakes Bay Health Centers Past Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2000 Fowler Grove Blvd
#140
Winter Garden, FL 34787

2000 Fowler Grove Blvd
Fl 3
Winter Garden, FL 34787
Phone (407) 521-3600

Interoperability endpoints

  • Direct secure messaging: sdelong70614@adventhealth.direct-ci.com

Organizations & group practices 7

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 2

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1497752679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD FL 3",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875050",
            "telephone_number": "407-614-0528",
            "fax_number": "407-614-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD FL 3",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875050",
            "telephone_number": "407-614-0528",
            "fax_number": "407-614-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291344500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CARTMILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.