MRS. ALVINA C SHANNON (PA-C) – Medical Physician Assistant, NPI 1720244957

MRS. ALVINA C SHANNON (PA-C) is a healthcare provider. based in Ellenwood, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 002735 (GA). The NPI Number for MRS. ALVINA C SHANNON (PA-C) is 1720244957

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
MRS. ALVINA C SHANNON (PA-C)
NPI
1720244957
Phone
(404) 403-9793
Address
4228 PARK PLACE CIR
Enumeration Date
7 August 2008
Last Update Date
17 December 2019

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
7707600066
Graduation Year
1995 (31 years ago)
PAC ID
1052445376
Group Practice PAC ID
9739260019
Professional Enrollment ID
I20100823000043
Address ID
GA300131281CO1680XSEXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:17State licenses:1Digital endpointsOther names

4,431 PHYSICIAN ASSISTANT in GA

Provider Addresses for MRS. ALVINA C SHANNON (PA-C)

  • 4228 PARK PLACE CIR

    ELLENWOOD, GA 302941550

    Phone: (404) 403-9793

    Type: Mailing

  • 4475 W VILLAGE PKWY

    ELLENWOOD, GA 302942869

    Phone: (770) 507-7950

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-08-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100823000043IPhysician AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J1100Injection, dexamethasone sodium phosphate, 1 mg17018$0
99213Established patient office or other outpatient visit, 20-29 minutes7059$0
99203New patient office or other outpatient visit, 30-44 minutes6161$0
87804Detection test by immunoassay with direct visual observation for influenza virus4623$0
U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc4138$0
View full utilization report →

Insurance plans in this area (ZIP 30294)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739260019View full group profile

Reviews

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Frequently asked questions

Does MRS. ALVINA C SHANNON (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MRS. ALVINA C SHANNON (PA-C) uses 1720244957.
Can I rely on MRS. ALVINA C SHANNON (PA-C) being an active provider?
As of the registry snapshot, MRS. ALVINA C SHANNON (PA-C) is marked active.
What is MRS. ALVINA C SHANNON (PA-C)'s specialty?
The listing groups MRS. ALVINA C SHANNON (PA-C) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MRS. ALVINA C SHANNON (PA-C) based?
MRS. ALVINA C SHANNON (PA-C) is tied to Ellenwood, Georgia in the data we show; additional addresses may exist on the full record.
Is the information about MRS. ALVINA C SHANNON (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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