Shannon Mallory Fatseas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004255RX Issued in OH

Practice address

3400 Olentangy River Rd
Columbus, OH 43202-1523

Phone

(614) 754-5500

Fax

(614) 754-5500

NPI assigned

Jan 26, 2010

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

Other names 1

• Ms. Shannon Kathleen Mallory Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ohio Gastroenterology Group, Inc.Group PAC ID 0143211284, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

Merit-based Incentive Payment System (MIPS)

Final score

83.93 of 100Reported as group

Quality

86

Promoting interoperability

100

Improvement activities

40

Cost

60.42

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.fatseas.p1@direct.cac.nextgenshare.com

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.

• Ohio Gastroenterology Group, Inc.

  • Gastroenterology Physician
  • Columbus, OH
  • NPI 1124197637
  Medicare reassignment Care Compare group
• Columbus Sleep Consultants Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Columbus, OH
  • NPI 1306809397
  Medicare reassignment NPD
• Columbus Arthritis Center, Inc.

  • Medical Specialty Clinic/Center
  • Columbus, OH
  • NPI 1952433898
  Medicare reassignment
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• The Union Hospital Association

  dba Union Hospital Professional Pharmacy

  • Community/Retail Pharmacy
  • Dover, OH
  • NPI 1023316700
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arthur G James Cancer Hospital and Research Institute

  • Special Hospital
  • Columbus, OH
  • NPI 1124127683
  Care Compare affiliation

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1972834240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-366-3687",
            "fax_number": "614-293-6176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATSEAS",
        "first_name": "SHANNON",
        "middle_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004255RX",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.004255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ohiogastro@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432021523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MALLORY",
            "middle_name": "KATHLEEN",
            "prefix": "MS.",
            "credential": "R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Omid Fathi, M.D.
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• Muhammadi Fatima
• Inna S Fatkins
• Theresa Fatorma
• Cameron Brayden Fattahi, MD
• Taylor Renea Faught, BSN, RN
• Jade A. Faul, LSW, LCDCII
• Kathleen Frances Faul
• Eileen Renee Faulds, APRNCNP

• Physician Assistant in Columbus, OH
• Providers in Columbus, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.