Patricia E Shambaugh, MD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101342 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 392-2877

NPI assigned

Jul 6, 2006

Last updated

Jun 15, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Patricia Elizabeth Tarantula Shambaugh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1831121664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-392-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBAUGH",
        "first_name": "PATRICIA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291039000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "SHAMBAUGH",
            "middle_name": "ELIZABETH TARANTULA",
            "credential": "PA C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sadiq S Shaik, M.D.
• Raisa Shaikh, PHARM D.
• Rami Mahmoud Shaker, MD
• Khalid Shakoor, DOM
• Shamal D Nadkarni MD PA
• Khaled M Shammout, MD
• Grace Yong Shan, PA-C
• Ganesh Shanardi, M.D.
• Shand's Hospital of Uf
• Shandra Phillips

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.