Shawn Nicole Preston Casavant, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA3403 Issued in FL

Practice address

1900 Don Wickham Drive
Ste 120
Clermont, FL 34711-1947

Phone

(352) 241-7050

Fax

(352) 241-7035

NPI assigned

Jul 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Shawn Nicole Preston Casavant Professional name

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

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 and National Provider Directory roles.

• South Lake Obstetrics & Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Clermont, FL
  • NPI 1497754121
  Medicare reassignment
• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032
  Medicare reassignment

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1952300535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DRIVE",
            "address_2": "STE 120",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111947",
            "telephone_number": "352-241-7050",
            "fax_number": "352-241-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DRIVE",
            "address_2": "STE 120",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111947",
            "telephone_number": "352-241-7050",
            "fax_number": "352-241-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON CASAVANT",
        "first_name": "SHAWN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA3403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291263500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "PRESTON CASAVANT",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Premise Health of Florida Medical PA
• Premise Health of Florida Medical PA
• Premise Health of Florida Medical PA
• Mason Lee Gardella Presley, DMD
• Prestige Medresource LLC
• Primary Partners, LLC
• Primephysiciansassociates LLC
• Grant Prince, M.D.
• Deanna Priolo
• Priority One Coaching, Counseling, & Consulting

• Medical Physician Assistant in Clermont, FL
• Providers in Clermont, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.