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

Individual provider Physician Assistant · NPI 1730840083

Shanice Shannon, PA is a Physician Assistant in Stockbridge, Georgia. Qualified in 2021, 5 years ago. Practices with South Atlanta Ear Nose and Throat PC, a 12-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2022
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

1101 Hospital Dr Ste 100A
Stockbridge, GA 30281-9076
Phone: (770) 474-7416
Fax: (770) 692-0761
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1730840083
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 7, 2022
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025

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 South Atlanta Ear Nose And Throat Pc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Stockbridge