MS. KERRY KATHLEEN SHUFFELBOTTOM (PA-C) – Physician Assistant, NPI 1902102676
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. KERRY KATHLEEN SHUFFELBOTTOM (PA-C)
3408 Trout St
Brunswick, GA 315203622
Phone: (912) 590-0973
Fax: (912) 590-0180
Type: Location
2418 NNPTC CIRCLE
GOOSE CREEK, SC 29445
Phone: (843) 577-5011
Type: Mailing
5191 FIRST COAST TECH PKWY FL 3
JACKSONVILLE, FL 322240609
Phone: (904) 223-3321
Fax: (904) 223-2169
Type: Mailing
200 BLUE MOON XING STE 203
POOLER, GA 313229698
Phone: (912) 590-0973
Fax: (912) 590-0180
Type: Location
106 DAISY CT
SAVANNAH, GA 314041886
Phone: (843) 260-2492
Type: Mailing
604 W OGLETHORPE HWY
HINESVILLE, GA 313134415
Phone: (912) 910-3777
Fax: (912) 292-0005
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 80 Open Payments records for all available years, with a total value of $4,831.
Total Amount is formed as General ($4,831) + Research ($0) + Ownership ($0) = $4,831.
Last reported payment date: 2024-08-26 • Largest payer in this snapshot: Abbott Laboratories ($3,912).
Total Amount
$4,831
General + Research + Ownership
Payments
80
Total payment records
General Amount
$4,831
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-26
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2018-09-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180917000061 | I | Physician Assistant | GA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 73 | 64 | $0 |
| 80307 | Testing for presence of drug, by chemistry analyzers | 11 | 11 | $0 |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 11 | 11 | $0 |
Insurance plans in this area (ZIP 31520)
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