LILLIAN SHADE SHAFFER (MMS, PA-C) – Medical Physician Assistant, NPI 1154075752

LILLIAN SHADE SHAFFER (MMS, PA-C) is a healthcare provider. based in Cleveland, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials MMS, PA-C. They hold a License No. 2600 (AL). The NPI Number for LILLIAN SHADE SHAFFER (MMS, PA-C) is 1154075752

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
LILLIAN SHADE SHAFFER (MMS, PA-C)
NPI
1154075752
Phone
(423) 250-5551
Address
3770 Ocoee Pl NW
Enumeration Date
11 February 2022
Last Update Date
31 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2562918877
Graduation Year
2021 (5 years ago)
PAC ID
0244606325
Group Practice PAC ID
8527446301
Professional Enrollment ID
I20250603003337
Address ID
AL350553511CU117XXSEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,118 PHYSICIAN ASSISTANT in TN

Provider Addresses for LILLIAN SHADE SHAFFER (MMS, PA-C)

  • 3770 Ocoee Pl NW

    Cleveland, TN 373125638

    Phone: (423) 250-5551

    Fax: (423) 250-5556

    Type: Location

  • 6145 SHALLOWFORD RD STE 102

    CHATTANOOGA, TN 374217808

    Phone: (423) 893-6890

    Fax: (423) 648-1115

    Type: Mailing

  • 2005 EVANS LN NE

    CULLMAN, AL 350582057

    Phone: (662) 473-6293

    Type: Mailing

  • 117 2ND AVE SE

    CULLMAN, AL 350553511

    Phone: (256) 291-8877

    Fax: (256) 500-9311

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 236 Open Payments records for all available years, with a total value of $5,551.

Total Amount is formed as General ($5,551) + Research ($0) + Ownership ($0) = $5,551.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($1,166).

Total Amount

$5,551

General + Research + Ownership

Payments

236

Total payment records

General Amount

$5,551

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-06-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20221013003144IPhysician AssistantTNTBD
I20250603003337IPhysician AssistantALTBD

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 37312)

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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: 8527446301View full group profile
NameSpecialtyState
D E R M A T O L O G YAL
Rheumatology, Internal MedicineAL
Family PracticeAL
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL

Reviews

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Frequently asked questions

Does LILLIAN SHADE SHAFFER (MMS, PA-C) have a public NPI I can cite?
Public records show LILLIAN SHADE SHAFFER (MMS, PA-C) under NPI 1154075752.
Should I treat LILLIAN SHADE SHAFFER (MMS, PA-C) as an active provider?
Patients and plans typically see LILLIAN SHADE SHAFFER (MMS, PA-C) as active in the national extract.
Which specialty label fits LILLIAN SHADE SHAFFER (MMS, PA-C)?
NPPES ties LILLIAN SHADE SHAFFER (MMS, PA-C) to Medical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to LILLIAN SHADE SHAFFER (MMS, PA-C)?
LILLIAN SHADE SHAFFER (MMS, PA-C) is associated with Cleveland, Tennessee in the same public data insurers reference.
Why is information missing for LILLIAN SHADE SHAFFER (MMS, PA-C)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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