Shannon Khattak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0007435 Issued in CO

Practice address

10375 Park Meadows Dr Ste 270
Lone Tree, CO 80124-6760

Phone

(720) 749-5599

Fax

(720) 925-5897

NPI assigned

Apr 23, 2021

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Oliver Former name

Medicare fee-for-service enrollment

Enrolled in CO

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mountain View Pain SpecialistsGroup PAC ID 7911255013, 53 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

30.58 of 100Reported as group

Quality

9.59

Promoting interoperability

0

Improvement activities

0

Cost

68.57

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.oliver@3675.securemail.prognocis.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.

• Mountain View Pain Specialists

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Lone Tree, CO
  • NPI 1912403544
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1639751142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10375 PARK MEADOWS DR STE 270",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246760",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9888 E Vassar Dr Apt B106",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802315902",
            "country_code": "US",
            "telephone_number": "719-472-4816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007435",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "OLIVER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas James Kenney III, M.D.
• Anna Kerege, PA-C
• Dennis Keselman, DO
• Elizabeth Shoemaker Kevil, PT, DPT, OCS, CSCS
• Hashim W. Khan, M.D.
• Alexandra Marry Khoury
• Edmon Khoury, M.D.
• Stacey Kiefer
• Kathryn Killam, LCSW
• Robert A Kilpatrick

• Physician Assistant in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.