Active NPI
Shannon O'Bryan, PA
- Physician Assistant
- Cocoa Beach, FL
National Provider Identifier
1790720670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9101898
- Practice address
- 699 W Cocoa Beach Cswy
Suite 601
Cocoa Beach, FL 32931-3577 - Phone
- (321) 783-2486
- NPI assigned
- Jun 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9101898 | FL | Primary |
Addresses
Primary practice location
699 W Cocoa Beach Cswy
Suite 601
Cocoa Beach, FL 32931-3577
Mailing address
PO Box 561600
Rockledge, FL 32956-1600
Phone (321) 434-4656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9101898 | Other | FL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9101898 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790720670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 561600",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329561600",
"telephone_number": "321-434-4656",
"fax_number": "321-259-5130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "699 W COCOA BEACH CSWY",
"address_2": "SUITE 601",
"city": "COCOA BEACH",
"state": "FL",
"postal_code": "329313577",
"telephone_number": "321-783-2486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRYAN",
"first_name": "SHANNON",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9101898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PA9101898",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cocoa Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.