Alnissa Carter Shaw, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001000089 Issued in NC

Practice address

811 US Highway 70 W
Garner, NC 27529-2541

Phone

(919) 779-5079

Fax

(919) 779-9268

NPI assigned

Jun 5, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Matrix Occupational Health P.C.

  • Urgent Care Clinic/Center
  • Fayetteville, NC
  • NPI 1144279670
  NPD

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669631545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41008",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283091008",
            "telephone_number": "800-849-5609",
            "fax_number": "910-483-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 US HIGHWAY 70 W",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292541",
            "telephone_number": "919-779-5079",
            "fax_number": "919-779-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALNISSA",
        "middle_name": "CARTER",
        "name_prefix": "Dr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-03-07",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001000089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Awaits Mental Health Services PLLC
• Seth C Rumley DDS PA III
• Shaikh Medical Clinic, PA
• Ghulam Murtaza Shaikh, M.D.
• Deepti Sharma, MD
• Kerri Shaw
• Victoria Shawl, MA, NCC, LCMHC
• Sheepless Nights, LLC
• Kristen Amanda Shepherd, APRN
• Kimberly Anne Sherwin, MS CCC-SLP

• Medical Physician Assistant in Garner, NC
• Providers in Garner, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.