Chandelle Eilene Shannon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011252 Issued in MI

Practice address

3265 Five Points Dr Ste a
Auburn Hills, MI 48326-2337

Phone

(248) 609-1234

Fax

(248) 290-9643

NPI assigned

Aug 25, 2022

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

• Chandelle Eilene Keller Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Hani Mekhael MD II PLLCGroup PAC ID 7012392897, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hani Mekhael MD II PLLC

  • Child & Adolescent Psychiatry Physician
  • Auburn Hills, MI
  • NPI 1174250658
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1710606314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 FIVE POINTS DR",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262337",
            "telephone_number": "248-609-1234",
            "fax_number": "248-290-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 FIVE POINTS DR STE A",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262337",
            "telephone_number": "248-609-1234",
            "fax_number": "248-290-9643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7433 Sauterne St",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483222818",
            "country_code": "US",
            "telephone_number": "717-639-5539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CHANDELLE",
        "middle_name": "EILENE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "1191042",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANDELLE",
            "last_name": "KELLER",
            "middle_name": "EILENE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Seipke
• Vivienne Ruth Walton Sejat, LMSW
• Tonya Julynn Sellers, RN
• Shraddha Sengaonkar
• Mihaela Sescioreanu, MD
• Avi Atul Sharma
• Diana Sharmazanov
• Simone Shaw
• Joseph John Sheena Jr., DDS
• Vicki Lynn Sherry, MSW., LMSW

• Physician Assistant in Auburn Hills, MI
• Providers in Auburn Hills, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.