Nicole Shannon, PA-C is a medicare enrolled "Internal Medicine - Cardiovascular Disease" in Fredericksburg, Virginia. Her current practice location is
406 Chatham Square Office Park, Fredericksburg, Virginia. You can reach out to her office (for appointments etc.) via phone at
(540) 666-6181.
Nicole Shannon is licensed to practice in Virginia (license number 0110009187) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1952090268.
Provider's Profile
Full Name | Nicole Shannon |
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Gender | Female |
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Speciality | Internal Medicine - Cardiovascular Disease |
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Location | 406 Chatham Square Office Park, Fredericksburg, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952090268
- Provider Enumeration Date: 05/03/2023
- Last Update Date: 05/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 9931568516
- Enrollment ID: I20230629001394
Medical Identifiers
Medical identifiers for Nicole Shannon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952090268 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 0110009187 (Virginia) | Secondary |
207RC0000X | Internal Medicine - Cardiovascular Disease | 0110009187 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Shannon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nicole Shannon, PA-C 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 Ph: (540) 903-4135 | Nicole Shannon, PA-C 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 Ph: (540) 666-6181 |
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