Nicole Shannon, PA-C

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

0110009187 Issued in VA

Practice address

406 Chatham Square Office Park
Fredericksburg, VA 22405-2585

Phone

(540) 666-6181

NPI assigned

May 3, 2023

Last updated

May 3, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Fredericksburg Emergency Medical Alliance, Inc.

  • Emergency Medicine Physician
  • Fredericksburg, VA
  • NPI 1396779153
  Medicare reassignment
• Premier Cardiac and Vascular LLC

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1366905523
  Medicare reassignment

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1952090268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052585",
            "telephone_number": "540-903-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052585",
            "telephone_number": "540-666-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110009187",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0110009187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyeba Shahid
• Peter Shahid, MD
• Mohammad Abid Shakib
• Shalomy's Caring Hands
• Attia Shams, PHARM-D
• Alisha Shappley
• Calista N Shardlow, LPC
• Hoordad Sharif
• Nathifah Sharif
• Sharing Hearts Home Healthcare LLC

• Cardiovascular Disease Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Cardiovascular Disease Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.