NPIMap

Individual provider Active NPI

Ketevan Shonia

  • Physician Assistant
  • Merrill, WI
National Provider Identifier
1518642271
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3333 E Main St
Merrill, WI 54452-8959
Phone
(715) 539-5600
NPI assigned
Jun 20, 2023
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3333 E Main St
Merrill, WI 54452-8959

Mailing address

3333 E Main St
Merrill, WI 54452-8959

Other names 1

  • Katie Shonia Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909002546 WI Practitioner - Physician Assistant 3870095649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

333 Pine Ridge Blvd
Wausau, WI 54401-4102

333 Pine Ridge Blvd
Wausau, WI 54401-4120
Phone (715) 847-2121

3333 E Main St
Merrill, WI 54452-8959
Phone (715) 539-5600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3333 E Main St
Merrill, WI 54452
Phone (715) 536-2463

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Interoperability endpoints

  • Direct secure messaging: kshonia380899@direct.aspirus.org

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1518642271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E MAIN ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544528959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E MAIN ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544528959",
            "telephone_number": "715-539-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHONIA",
        "first_name": "KETEVAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "SHONIA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Merrill, WI

Sources for this page

Verify at the official NPI Registry.