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

Shannon K Hailey, PA-C

Individual provider Surgical Physician Assistant · NPI 1336420561

Shannon K Hailey, PA-C is a Physician Assistant in Overland Park, Kansas. Qualified in 2011, 15 years ago. Practices with Dickson Diveley Midwest Orthopaedic Clinic LLC, a 68-clinician group and accepts Medicare assignment. Licensed in Kansas and Missouri.

Years since qualifying
15
Licensed in
KS, MO
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10777 Nall Ave Ste 300
Overland Park, KS 66211-1330
Phone: (913) 563-6630
Fax: (913) 563-6699
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 15-01479 (KS)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 2015010264 (MO)

Record details

NPI number1336420561
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 1, 2011
Last updated in NPPESOctober 3, 2022
Certification dateOctober 3, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Dickson Diveley Midwest Orthopaedic Clinic Llc — 68 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Overland Park