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

Shane Adam Daniell, PA

Individual provider Physician Assistant · NPI 1396187027

Shane Adam Daniell, PA is a Physician Assistant in Kingsport, Tennessee. Qualified in 2013, 13 years ago. Practices with Holston Medical Group PC, a 242-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
13
Licensed in
TN
In the registry since
2013
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

105 W Stone Dr Ste 3A
Kingsport, TN 37660-3365
Phone: (423) 392-6200
Fax: (423) 392-6593
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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 PA2379 (TN)

Record details

NPI number1396187027
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 23, 2013
Last updated in NPPESDecember 16, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Holston Medical Group Pc — 242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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