SHANNON KELLY (AA-C) – Anesthesiologist Assistant, NPI 1013335413

SHANNON KELLY (AA-C) is a healthcare provider. based in Parma, Ohio. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials AA-C. They hold a License No. 000227 (OH). The NPI Number for SHANNON KELLY (AA-C) is 1013335413

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON KELLY (AA-C)
NPI
1013335413
Phone
(440) 503-1478
Address
4711 TUXEDO AVE
Enumeration Date
2 April 2014
Last Update Date
27 December 2021

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
4403238515
Graduation Year
2013 (13 years ago)
PAC ID
3375776487
Group Practice PAC ID
7214902170
Professional Enrollment ID
I20140425000147
Address ID
OH440355902EL630XXSTXX400

Contacts

Secure Messaging
skelly92390@direct.metrohealth.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:12State licenses:1Other namesUpdated within 12 months

424 ANESTHESIOLOGY ASSISTANT in OH

Provider Addresses for SHANNON KELLY (AA-C)

  • 4711 TUXEDO AVE

    PARMA, OH 441341029

    Phone: (440) 503-1478

    Type: Mailing

  • 2500 METROHEALTH DR

    CLEVELAND, OH 441091900

    Phone: (216) 778-7800

    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: 2014-04-25

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
I20140425000147IAnesthesiology AssistantOHTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44134)

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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: 7214902170View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YOH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Anesthesiology AssistantFL
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YSHOUF
Certified Registered Nurse Anesthetist (Crna)OH

Reviews

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Frequently asked questions

Is SHANNON KELLY (AA-C) listed with a National Provider Identifier?
Yes — SHANNON KELLY (AA-C) has NPI 1013335413 on file in the registry.
Would SHANNON KELLY (AA-C) appear as active to a payer?
You can treat SHANNON KELLY (AA-C) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe SHANNON KELLY (AA-C)'s focus?
For SHANNON KELLY (AA-C), the primary taxonomy reads as Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Is SHANNON KELLY (AA-C) associated with Parma?
Public fields place SHANNON KELLY (AA-C) around Parma, Ohio. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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