Shannon K Holloman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004593 Issued in VA

Practice address

600 Gresham Dr Ste 204
Norfolk, VA 23507-1904

Phone

(757) 388-5680

NPI assigned

Jun 16, 2014

Last updated

Aug 26, 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 1

Addresses

Other identifiers 5

Other names 1

• Shannon Kathleen Andy Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
• Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
• Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.holloman@hrosm.cernerdirect.com
• Direct secure messaging: sholloman@hrosm.gwaydirect.com

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment Care Compare group NPD

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

• Sentara Hospitals

  dba Sentara Nightingale

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Obici Hospital

  • General Acute Care Hospital
  • Suffolk, VA
  • NPI 1376540138
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Norfolk General Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Virginia Beach General Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1629038336
  Care Compare affiliation
• Sentara Albemarle Regional Medical Center

  dba Sentara Albemarle Medical Center

  • General Acute Care Hospital
  • Elizabeth City, NC
  • NPI 1245211168
  Care Compare affiliation

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1528472818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Thimble Shoals Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064562",
            "country_code": "US",
            "telephone_number": "757-873-1554",
            "fax_number": "757-873-3239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOMAN",
        "first_name": "SHANNON",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "10160253P",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1528472818",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528472818",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1528472818",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD SUPPLEMENT",
            "identifier": "565258",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.holloman@hrosm.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "730 Thimble Shoals Blvd Ste 130",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "ANDY",
            "middle_name": "KATHLEEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lakisha Holley
• Karen Holliday
• Alana R Hollings, PSYD
• Jane Hollingsworth, PSY.D.
• Jenifer Hollingsworth
• Stanley Holloway
• Ellen Long Hollyfield, RPH
• Nitasha Holman
• Dawayne Darren Holmes
• Rishardia Holmes, CMT

• Physician Assistant in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.