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SHANNON WHITLOCK PAC
NPI 1932274578
Physician Assistant - Medical in Prescott, AZ

Active since November 21, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
830 AINSWORTH DR, PRESCOTT, AZ 86301(928) 777-5800(928) 776-0405 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon Whitlock Pac NPPES

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

SHANNON WHITLOCK PAC (NPI 1932274578) is an individual medical provider in Prescott, Arizona, licensed in Arizona (10942) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of George Washington University School Of Medicine (2005).

NPPES Registry Identity

NPI1932274578
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSHANNON WHITLOCKCredential: PAC
Location Address830 AINSWORTH DRPrescott, AZ 86301-1630
Mailing Address801 York StManitowoc, WI 54220-4630 · (920) 663-9008 · Fax (920) 684-1439
Phone(928) 777-5800
Fax(928) 776-0405
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 2005
Enumeration DateNovember 21, 2006
Last NPPES UpdateApril 24, 2025
NPPES CertifiedApril 24, 2025
✔ NPI 1932274578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in AZ · 10942✔ Licensed in VA · 0110002157
830 AINSWORTH DR, Prescott, AZ 86301
Open in Google Maps ↗

Secondary Practice Locations 4

Location 1203 S Candy Ln # 14Cottonwood, AZ 86326-4120 · Phone (928) 639-3387 · Fax (928) 776-0405
Location 2820 Ainsworth Dr Ste APrescott, AZ 86301-1613 · Phone (928) 777-5800 · Fax (928) 776-0405
Location 32820 N Glassford Hill Rd Ste 103Prescott Valley, AZ 86314-2256 · Phone (928) 772-8553 · Fax (928) 776-0405
Location 42820 N Glassford Hill Rd Ste 107Prescott Valley, AZ 86314-2256 · Phone (928) 772-8553 · Fax (928) 776-0405

Other Identifiers 1

Medicaid173121AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Whitlock Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810907219
PECOS Enrollment IDI20250404001742
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.

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
Quality100
Improvement Activities40

Other Providers at the Same Location NPPES 14

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

CECILY KAE LUNT MSN, FNP
Nurse Practitioner
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 776-0325
JULIETTE MARGARET MCCAFFREY PA-C
Physician Assistant
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800
EMILY BREWTON PA-C
Physician Assistant
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800
MR. HA LE PHAM PA-C
Physician Assistant
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800
FOREFRONT DERMATOLOGY, S.C.
Dermatology
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800
SANDRA-LYNN FRANCES HUTCHISON P.A.
Physician Assistant
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800
DR. PATRICIA I CEBALLOS M.D.
Dermatology
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800
KIRSTEN FLYNN MD
Dermatology
830 AINSWORTH DR
PRESCOTT, AZ 86301
Yavapai County (928) 777-5800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Whitlock's NPI number?

The NPI number for Shannon Whitlock is 1932274578. It was assigned to this individual provider in the NPPES registry on November 21, 2006.

Where is Shannon Whitlock located?

Shannon Whitlock practices at 830 Ainsworth Dr, Prescott, AZ 86301. The listed phone number is (928) 777-5800.

What is Shannon Whitlock's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Shannon Whitlock enrolled in Medicare?

Yes. Shannon Whitlock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shannon Whitlock accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. and UnitedHealthcare list Shannon Whitlock as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Whitlock was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.