Timothy Richard Shaner, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3603 Issued in FL

Practice address

4132 Woodlands Pkwy
Palm Harbor, FL 34685-3494

Phone

(727) 786-5100

Fax

(727) 789-8344

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  NPD
• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • The Villages, FL
  • NPI 1417115908
  NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1730132408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 WOODLANDS PKWY",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346853494",
            "telephone_number": "727-786-5100",
            "fax_number": "727-789-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANER",
        "first_name": "TIMOTHY",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pooja R Shah
• Germin W Shaker
• Marko Shaker
• Michael M Shaker
• Shane Lynn ( S&D Behavioral Health)
• Lauri A. Shannon, LCSW
• Jerrold Sharkey, MD
• Kathleen Shea, PH.D.
• Mary Eileen Sheahan, LCSW
• Jason Christopher Sheakoski, PHARMD

• Physician Assistant in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.