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

MS. Shannon Dre Chisholm, PA-C

Individual provider Surgical Physician Assistant · NPI 1700824638

MS. Shannon Dre Chisholm, PA-C is a Physician Assistant in Daytona Beach, Florida. Qualified in 1999, 27 years ago. Practices with Halifax Healthcare Systems Inc, a 339-clinician group and accepts Medicare assignment. Licensed in Florida and Texas.

Years since qualifying
27
Licensed in
FL, TX
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

595 N Williamson Blvd
Daytona Beach, FL 32114-7185
Phone: (872) 231-3162
Fax: (702) 977-1496
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9107966 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA02625 (TX)

Record details

NPI number1700824638
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 3, 2006
Last updated in NPPESOctober 3, 2025
Certification dateOctober 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Halifax Healthcare Systems Inc — 339 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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