Individual provider Active NPI

Matthew Shannon, CAA

  • Anesthesiologist Assistant
  • Savannah, GA
National Provider Identifier
1619580800
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA824 Issued in FL
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 350-8980
NPI assigned
Aug 26, 2020
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA824 FL Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

166 Wilmington Island Rd Unit a
Savannah, GA 31410-3862
Phone (678) 983-3170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201124003407 GA Practitioner - Anesthesiology Assistant 4587075445 Reassigns benefits to 3 organizations
I20231012000500 FL Practitioner - Anesthesiology Assistant 4587075445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 461-8231

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
10061GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Jul 23, 2021 Accepting new patients
Baycare Medical Group, Inc CurrentSince Dec 30, 2024 Accepting new patients
SE Georgia Anesthesia, LLC CurrentSince Oct 30, 2023 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Nov 5, 2020 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

Organizations & group practices 6

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 1

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": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1619580800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 WILMINGTON ISLAND RD UNIT A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314103862",
            "telephone_number": "678-983-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MATTHEW",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.