SHAWN MCNICHOL (NPI# 1487207213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487207213 |
| Entity Type | Individual |
| Full Name | SHAWN MCNICHOL |
| Credential | PA |
| Practice Address |
601 E Dixie Ave Ste 804 Leesburg FL 34748-5994 |
| Mailing Address |
6818 Slaven Dr Orlando FL 32819-4724 |
| Practice Telephone | 3523232337 |
| Mailing Telephone | 3039999611 |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2020-08-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 105590600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6818 Slaven Dr, Orlando, FL 328194724 | 3039999611 |
| Street Address |
601 E DIXIE AVE STE 804 |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-5994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457825093 | Grace Christine Berardini | Physician Assistant | 19415 Deerfield Ave Ste 314, Leesburg, VA 20176-8472 | 2019-01-16 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1477052603 | Charu Gupta | Physician Assistant | 635 Potomac Station Dr Ne, Leesburg, VA 20176-1818 | 2018-02-02 |
| 1255876041 | John Edward Kelly | Physician Assistant | 1340 Citizens Blvd, Leesburg, FL 34748-3924 | 2017-01-03 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| 1043651342 | Kristin Marie Kaiser | Physician Assistant | 19465 Deerfield Ave Ste 408, Leesburg, VA 20176-1707 | 2013-07-15 |
| 1326370438 | Kimberly Brooke Fields | Physician Assistant | 19500 Sandridge Way Ste 170, Leesburg, VA 20176 | 2010-02-01 |
| 1386702652 | Patricia Ann Nicholson | Physician Assistant | 224b Cornwall St Nw, Loudoun Free Clinic, Leesburg, VA 20176-2701 | 2006-12-05 |
| 1790737609 | Stephen Joseph Signore | Physician Assistant | 401 W North Blvd, Mid-florida Primary Care, Pa, Leesburg, FL 34748-5044 | 2006-05-17 |
| 1811966377 | Sanjeev Singh | Physician Assistant | 2 Cardinal Park Dr Se, Suite 103a, Leesburg, VA 20175-4448 | 2006-03-16 |
| Find all providers in LEESBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.