Individual provider Active NPI

Paige Shannon, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1689045601
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004507 Issued in OH
Practice address
2323 W 5TH Ave
Suite 225
Columbus, OH 43204-4899
Phone
(614) 224-6420
NPI assigned
Oct 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.004507 OH Primary

Addresses

Primary practice location

2323 W 5TH Ave
Suite 225
Columbus, OH 43204-4899

Mailing address

1024 Folkestone Rd
Columbus, OH 43220-3706
Phone (317) 697-2561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20200821002175 FL Practitioner - Physician Assistant 2264732239 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Carenow Urgent Care LLCGroup PAC ID 1759666050, 57 clinicians

Practice addresses (Care Compare)

1328 N Woodland Blvd
Deland, FL 32720-2203
Phone (386) 738-0574

410 E Altamonte Dr
Suite 1020
Altamonte Springs, FL 32701-4657
Phone (615) 373-7600

5102 Sr
Suite 46
Sanford, FL 32771-9336
Phone (407) 410-8670

5845 Winter Garden Vineland Rd
Windermere, FL 34786-6124
Phone (407) 230-1682

628 Cagan View Rd
Clermont, FL 34714-6566
Phone (352) 242-1988

805 County Rd
Suite 466
Lady Lake, FL 32159-4205
Phone (352) 674-9218

8972 Turkey Lake Rd
Orlando, FL 32819-7377
Phone (407) 226-1906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.004507OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Aug 10, 2020 Accepting new patients
Urgent Care Centers of Brevard County LLC Physician Assistant CurrentSince Nov 27, 2020 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Aug 10, 2020 Accepting new patients
Heathrow Internal Medicine LLC Past Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

105 S Banana River Blvd
Cocoa Beach, FL 32931
Phone (321) 783-3362

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1689045601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 FOLKESTONE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203706",
            "telephone_number": "317-697-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W 5TH AVE",
            "address_2": "SUITE 225",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432044899",
            "telephone_number": "614-224-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "PAIGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-16",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.