Shannon Mohollen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0011500 Issued in DE

Practice address

405 Silverside Rd Ste 104
Wilmington, DE 19809-1768

Phone

(844) 365-7246

Fax

(844) 516-0080

NPI assigned

Jan 27, 2021

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

• Shannon Bradley Former name

Medicare fee-for-service enrollment

Enrolled in DE, PA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

71.05 of 100Reported as group

Quality

87.44

Promoting interoperability

0

Improvement activities

40

Cost

81.09

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.mohollen@advocaredoctors.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696

  PA

  Medicare reassignment Care Compare group NPD
• Center for Interventional Pain Spine LLC

  • Interventional Pain Medicine Physician
  • Middletown, DE
  • NPI 1144527003

  PA

  Medicare reassignment NPD
• Advocare , LLC

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Center for Interventional Pain Spine LLC

  • Durable Medical Equipment & Medical Supplies
  • Elkton, MD
  • NPI 1447906706
  NPD

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1659962207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 CARTER DR STE A",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095845",
            "telephone_number": "844-365-7246",
            "fax_number": "844-516-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SILVERSIDE RD STE 104",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198091768",
            "telephone_number": "844-365-7246",
            "fax_number": "844-516-0080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Arrandale Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Exton",
            "state": "PA",
            "postal_code": "193412695",
            "country_code": "US",
            "telephone_number": "844-365-7246",
            "fax_number": "844-516-0080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4701 Ogletown Stanton Rd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132079",
            "country_code": "US",
            "telephone_number": "844-365-7246",
            "fax_number": "844-516-0080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3105 Limestone Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198082156",
            "country_code": "US",
            "telephone_number": "844-365-7246",
            "fax_number": "844-516-0080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1197 Airport Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "DE",
            "postal_code": "199636418",
            "country_code": "US",
            "telephone_number": "844-365-7246",
            "fax_number": "844-516-0080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHOLLEN",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062225",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BRADLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dipika J Modi
• Arthur Moffa
• Parham Moftakhar, MD
• Caitlin Grimes Mogelesky
• Dillibai Mohan, NP-C
• Meredith Dyann Mohr
• Valarie Molaison
• Kenneth A. Molczan, APN
• Timothy Moley, OTR/L
• Charles Molins, LCSW

• Physician Assistant in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.