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

Sophie Ann Shackley, PA-C

Individual provider Medical Physician Assistant · NPI 1376165548

Sophie Ann Shackley, PA-C is a Physician Assistant in Fitchburg, Wisconsin. Qualified in 2021, 5 years ago. Practices with University of Wisconsin Medical Foundation Inc, a 2,536-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2020
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

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone: (608) 274-5300
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 8537-23 (WI)

Record details

NPI number1376165548
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMay 11, 2020
Last updated in NPPESMarch 13, 2026
Certification dateMarch 13, 2026

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 University Of Wisconsin Medical Foundation Inc — 2536 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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