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

Mary Virginia Shoup

Individual provider Physician Assistant · NPI 1275209025

Mary Virginia Shoup is a Physician Assistant in Thomasville, Georgia. Qualified in 2021, 5 years ago. Practices with Ccsg, Inc, a 26-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
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Practice location Address checks out

915 Gordon Ave
Thomasville, GA 31792-6614
Phone: (229) 228-2799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Gordon Ave. At Mimosa Drive., Thomasville, GA 31792 — (229) 228-2000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1275209025
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 20, 2021
Last updated in NPPESSeptember 3, 2021
Certification dateAugust 23, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ccsg, Inc — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Thomasville