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

Shataesia S Booker, PA

Individual provider Physician Assistant · NPI 1114786795

Shataesia S Booker, PA is a Physician Assistant in Chapel Hill, North Carolina. Qualified in 2023, 3 years ago. Practices with Mainstreet and Kidsstreet of North Carolina PLLC, a 76-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
3
Licensed in
NC
In the registry since
2024
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

1728 Fordham Blvd Ste 151
Chapel Hill, NC 27514-2332
Phone: (910) 429-0647
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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 0010-14085 (NC)

Record details

NPI number1114786795
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 18, 2024
Last updated in NPPESJune 11, 2024
Certification dateJune 11, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Mainstreet And Kidsstreet Of North Carolina Pllc — 76 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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