MS. KERRY KATHLEEN SHUFFELBOTTOM PA-C
NPI 1902102676
Physician Assistant in Pooler, GA

Q: What is Kerry Shuffelbottom's NPI number?

The NPI number for Kerry Shuffelbottom is 1902102676. It was assigned to this individual provider in the NPPES registry on January 28, 2011.

Q: What is Kerry Shuffelbottom's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since January 28, 2011PECOS Enrolled

100/100

CMS Quality Rating

200 BLUE MOON XING STE 203, POOLER, GA 31322(912) 590-0973(912) 590-0180 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 12, 2023, Jun 10, 2022, May 5, 2022 and 1 more (4 updates tracked since 2016).

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About Ms. Kerry Kathleen Shuffelbottom Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KERRY KATHLEEN SHUFFELBOTTOM PA-C (NPI 1902102676) is an individual physician assistant in Pooler, Georgia, licensed in South Carolina (2131) and active in the NPI registry since January 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902102676

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. KERRY KATHLEEN SHUFFELBOTTOMCredential: PA-C

Location Address200 BLUE MOON XING STE 203Pooler, GA 31322-9698

Mailing Address5191 First Coast Tech Pkwy Fl 3Jacksonville, FL 32224-0609 · (904) 223-3321 · Fax (904) 223-2169

Phone(912) 590-0973

Fax(912) 590-0180

Sole ProprietorNo

Enumeration DateJanuary 28, 2011

Last NPPES UpdateOctober 12, 20234 updates tracked since enumeration

NPPES CertifiedOctober 12, 2023

✔ NPI 1902102676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in SC · 2131

Definition

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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 2131 (SC)

200 BLUE MOON XING STE 203, Pooler, GA 31322

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Other Identifiers 2

OtherY06PSFL · Bcbs

Medicaid0032613-00FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kerry Kathleen Shuffelbottom Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

200 services132 patients

Testing for presence of drug, by chemistry analyzers 80307

Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.

36 services35 patients

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 G0483

A definitive drug test identifies specific drugs in your system. It uses advanced methods like gc/ms and lc/ms, which can distinguish between different types of drugs but not necessarily their 3D forms. This test offers detailed results to support your healthcare decisions.

35 services34 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

33 services29 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

28 services28 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

26 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31322 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SALAETHIA MARTRIA CRAWFORD

Nurse Practitioner (Family)