Individual provider Active NPI

Shannon Lindsey Burke

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1932042264
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121923 Issued in FL
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Apr 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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 PA9121923 FL Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sburke28848@direct.watsonclinicad.com Direct Watson Clinic LLP

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
I20260626000364 FL Practitioner - Physician Assistant 5294208633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1775865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1932042264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "SHANNON",
        "middle_name": "LINDSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-11",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sburke28848@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.