Individual provider Active NPI

Shannon Lee Aurelius

  • Physician Assistant
  • Venice, FL
National Provider Identifier
1881257236
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
517 Riviera St
Venice, FL 34285-2827
Phone
(941) 244-9524
NPI assigned
Apr 20, 2019
Last updated
Oct 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

517 Riviera St
Venice, FL 34285-2827

Mailing address

517 Riviera St
Venice, FL 34285-2827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240829003193 AZ Practitioner - Physician Assistant 2062848112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Northern Arizona Healthcare LLCGroup PAC ID 1557875481, 12 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1895 N Jasper Dr
Suite 3
Flagstaff, AZ 86001-1632
Phone (928) 913-8800

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

3367 N NC 16 Business Hwy
Denver, NC 28037-8265
Phone (419) 221-6717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Oct 1, 2024 Accepting new patients

Locations

1298 W Finnie Flat Rd
Ste 101
Camp Verde, AZ 86322
Phone (928) 639-5555

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1895 N Jasper Dr
Ste 3
Flagstaff, AZ 86001
Phone (928) 213-6385

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1881257236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 RIVIERA ST",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 RIVIERA ST",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852827",
            "telephone_number": "941-244-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AURELIUS",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-20",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.