Individual provider Active NPI

Shawn D Taylor, PA-C

  • Physician Assistant
  • Cherokee, NC
National Provider Identifier
1881783728
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104301 Issued in FL
Practice address
1 Hospital Rd
Cherokee Indian Hospital
Cherokee, NC 28719
Phone
(828) 497-9163
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9104301 FL
Physician Assistant 363A00000X PA9104301 FL Primary

Addresses

Primary practice location

1 Hospital Rd
Cherokee Indian Hospital
Cherokee, NC 28719

Mailing address

906 Palm Blvd S
Niceville, FL 32578-2603
Phone (850) 517-9851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081218000720 FL Practitioner - Physician Assistant 5799779484 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crestview Urgent Care, Inc.Group PAC ID 3678614534, 12 clinicians

Practice addresses (Care Compare)

2400 As Ferdon Blvd
Crestview, FL 32536-6459

2400 S Ferdon Blvd
Suite a
Crestview, FL 32536-6459
Phone (850) 398-8668

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104301FLMDPhysician Assistant
PA 9104301FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Dec 16, 2022 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jul 1, 2018 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jul 1, 2018 Accepting new patients
Cep America LLC CurrentSince Dec 16, 2022 Accepting new patients
Niceville Urgent Care LLC CurrentSince Jan 22, 2023 Accepting new patients
Oakfield Drive Emergency Physicians LLC Physician Assistant Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Medical Past Accepting new patients
Terra Ceia Emergency Physicians LLC Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

906 Palm Blvd S
Niceville, FL 32578
Phone (850) 517-9851

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7208/brand/2/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1881783728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 PALM BLVD S",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782603",
            "telephone_number": "850-517-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL RD",
            "address_2": "CHEROKEE INDIAN HOSPITAL",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "28719",
            "telephone_number": "828-497-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SHAWN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9104301",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, NC

Sources for this page

Verify at the official NPI Registry.