Shannon Dre Chisholm, PA-C
NPI 1700824638ActiveIndividual· Physician Assistant· Daytona Beach, FL
Physician Assistant (PA-C) with Halifax Healthcare Systems Inc and 1 other group, practicing in Daytona Beach, Florida. Medicare paid $8,184 for services to 99 patients in 2024.
Overview
| NPI | 1700824638 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | Yes |
| NPI issued | Jun 3, 2006 |
| Last updated in NPPES | Oct 3, 2025 |
| Certified by provider | Oct 3, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA9107966 | FL |
| Physician Assistant, Surgical | 363AS0400X | PA02625 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (FL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 99 |
|---|---|
| Services billed | 151 across 5 procedure codes |
| Paid by Medicare | $8,184 |
Education and affiliations
| Graduation year | 1999 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Halifax Healthcare Systems IncDaytona Bch, FL · 356 clinicians
- M Medical Group Se LLCFt Worth, TX · 19 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 116 physician assistants in Daytona Beach · All physician assistants in Florida