Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Petronella Shock, PA

Individual provider Physician Assistant · NPI 1962439745

Lisa Petronella Shock, PA is a Physician Assistant in Raleigh, North Carolina. Licensed in North Carolina and Tennessee. Registered with an NPI since 2006.

Licensed in
NC, TN
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4909 Green Rd
Raleigh, NC 27616-3418
Phone: (919) 790-0288
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 102885 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 6237 (TN)

Record details

NPI number1962439745
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 27, 2006
Last updated in NPPESJuly 10, 2025
Certification dateJuly 10, 2025

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