Shanice Shannon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1101 Hospital Dr Ste 100a
Stockbridge, GA 30281-9076

Phone

(770) 474-7416

Fax

(770) 692-0761

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Atlanta Ear Nose and Throat PCGroup PAC ID 7113908302, 12 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

57.28 of 100Reported as group

Quality

60.36

Promoting interoperability

0

Improvement activities

40

Cost

80.58

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.

• South Atlanta Ear Nose & Throat, PC

  • Specialist
  • Fayetteville, GA
  • NPI 1548697196
  Medicare reassignment Care Compare group
• Southern Crescent ENT, P.C.

  • Otolaryngology Physician
  • Stockbridge, GA
  • NPI 1841281391
  NPD
• ENT of Georgia, LLC

  • Otolaryngology Physician
  • Atlanta, GA
  • NPI 1922046424
  NPD (past)

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1730840083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HOSPITAL DR STE 100A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819076",
            "telephone_number": "770-474-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HOSPITAL DR STE 100A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819076",
            "telephone_number": "770-474-7416",
            "fax_number": "770-692-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "SHANICE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nemil Shah, M.D.
• Pravin Shah
• Tallapragada Shankar, MD
• Andrea Shannon, D.C.
• Larry Roland Shannon II, MD
• Anand T Shantha, M.D.
• Sarah Shapiro, PA-C
• Toshi Shareef
• Omar Mohammed Shariff, D.D.S.
• Pallavi Sharma, M.D.

• Physician Assistant in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.