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

Shannon Whitlock, PAC

Individual provider Medical Physician Assistant · NPI 1932274578

Shannon Whitlock, PAC is a Physician Assistant in Prescott, Arizona. Graduated from George Washington University School of Medicine in 2005, 21 years ago. Practices with Forefront Dermatology SC, a 645-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Arizona and Virginia.

Years since qualifying
21
Trained at
George Washington University School of Medicine
Licensed in
AZ, VA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

830 Ainsworth Dr
Prescott, AZ 86301-1630
Phone: (928) 777-5800
Fax: (928) 776-0405
Show map & directions

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

Additional practice locations (4)

  • 203 S Candy Ln # 14, Cottonwood, AZ 86326-4120 — (928) 639-3387
  • 820 Ainsworth Dr Ste A, Prescott, AZ 86301-1613 — (928) 777-5800
  • 2820 N Glassford Hill Rd Ste 107, Prescott Valley, AZ 86314-2256 — (928) 772-8553
  • 2820 N Glassford Hill Rd Ste 103, Prescott Valley, AZ 86314-2256 — (928) 772-8553

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10942 (AZ)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 0110002157 (VA)

Record details

NPI number1932274578
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedNovember 21, 2006
Last updated in NPPESApril 24, 2025
Certification dateApril 24, 2025
Mailing address801 York St, Manitowoc, WI 54220-4630

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Forefront Dermatology Sc — 645 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Prescott