Individual provider Active NPI

Shauntel Latryce Davis, PA-C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1932675923
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0007328 Issued in MD
Practice address
1885 Terrier Ave
Virginia Beach, VA 23461-2203
Phone
(757) 953-9902
Fax
(757) 953-9908
NPI assigned
Oct 17, 2018
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0007328 MD Primary
Physician Assistant 363A00000X 0110011843 VA

Addresses

Primary practice location

1885 Terrier Ave
Virginia Beach, VA 23461-2203

Mailing address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (800) 465-3203

Other practice location 1

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (800) 465-3203

Other practice location 2

1605 General Booth Blvd
Virginia Beach, VA 23454-5691
Phone (757) 721-0512

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExhcange@patientfirst.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20191218001951 DC Practitioner - Physician Assistant 7517391964 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0007328MDMDPhysician Assistant
0110011843VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Oct 23, 2019 Accepting new patients
MNR Industries, LLC CurrentSince Oct 23, 2019 Accepting new patients
MNR Industries,LLC CurrentSince Dec 1, 2019 Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

2006 Rock Spring Rd
Forest Hill, MD 21050
Phone (410) 569-0044

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

10416 Campus Way S
Upper Marlboro, MD 20774
Phone (301) 316-9620

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1932675923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "800-465-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 TERRIER AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234612203",
            "telephone_number": "757-953-9902",
            "fax_number": "757-953-9908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "800-465-3203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1605 General Booth Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234545691",
            "country_code": "US",
            "telephone_number": "757-721-0512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHAUNTEL",
        "middle_name": "LATRYCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007328",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011843",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExhcange@patientfirst.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1605 General Booth Blvd",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234545691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.