Shannon Wilkins, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004688RX Issued in OH

Practice address

406 S 15TH St
Coshocton, OH 43812-2285

Phone

(740) 295-3331

Fax

(740) 295-3332

NPI assigned

Jul 10, 2006

Last updated

Jul 12, 2016By 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 2

Addresses

Other names 1

• Miss Shannon Bordt-Scango Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1588698278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 N MAIN ST",
            "city": "MALTA",
            "state": "OH",
            "postal_code": "437589007",
            "telephone_number": "740-962-6111",
            "fax_number": "740-962-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S 15TH ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122285",
            "telephone_number": "740-295-3331",
            "fax_number": "740-295-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051578",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004688RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BORDT-SCANGO",
            "prefix": "MISS",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James V Wiandt, APRN
• David Elvin Wickham, P.T.
• Haley N Wiggins
• Mary R Wiggins
• Sally Jo Wiggins, CMS
• Becky Jo Williams
• Jamie Williams
• Janell Louise Williams
• Maliya Avyana Williams, STNA, MST
• Christine Lynette Wilson-Arnold, QMHS

• Physician Assistant in Coshocton, OH
• Providers in Coshocton, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.