Individual provider Active NPI

Shannon Smith Drachenberg, PA-C

  • Medical Physician Assistant
  • Austin, TX
National Provider Identifier
1790093805
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
5625 Eiger Rd
Suite 200
Austin, TX 78735-8976
Phone
(512) 892-7076
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

5625 Eiger Rd
Suite 200
Austin, TX 78735-8976

Mailing address

5625 Eiger Rd
Suite 200
Austin, TX 78735-8976
Phone (512) 892-7076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180611001777 TX Practitioner - Physician Assistant 6901151273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Austin Family Practice Clinic, PLLCGroup PAC ID 3678564358, 64 clinicians

Practice addresses (Care Compare)

5625 Eiger Rd
200 Premier Family Physicians
Austin, TX 78735-8977
Phone (512) 892-7076

5625 Eiger Rd
Suite 200
Austin, TX 78735-8982

Hospital & facility affiliations

  • Accentcare Home Health of Texas Home health agency, Austin, TX, CCN 747786

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: shannon.drachenberg.1@18292.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1790093805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358976",
            "telephone_number": "512-892-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358976",
            "telephone_number": "512-892-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRACHENBERG",
        "first_name": "SHANNON",
        "middle_name": "SMITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.