Organization Active NPI

Shannon Brackett Hinkle, PA-C, PLLC

  • Surgical Physician Assistant
  • Rocky Mount, NC
National Provider Identifier
1518991058
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA3510 Issued in FL
Legal business name
SHANNON BRACKETT HINKLE, PA-C, PLLC
Practice address
6411 Waters Edge Dr
Rocky Mount, NC 27803-8925
Phone
(252) 442-7462
Fax
(252) 446-7463
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Shannon Brackett Hinkle III, PA-C
Title
Owner
Phone
(252) 442-7462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X PA3510 FL Primary

Addresses

Primary practice location

6411 Waters Edge Dr
Rocky Mount, NC 27803-8925

Mailing address

6411 Waters Edge Dr
Rocky Mount, NC 27803-8925
Phone (252) 442-7462

Other names 1

  • Shannon Brackett Hinkle, PA-C, LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518991058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 WATERS EDGE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278038925",
            "telephone_number": "252-442-7462",
            "fax_number": "252-446-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 WATERS EDGE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278038925",
            "telephone_number": "252-442-7462",
            "fax_number": "252-446-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON BRACKETT HINKLE, PA-C, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HINKLE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "BRACKETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-442-7462",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA3510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shannon Brackett Hinkle, PA-C, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.