Ms Kerry Kathleen Shuffelbottom, PA-C - Medicare Physician Assistant in Pooler, GA

Ms Kerry Kathleen Shuffelbottom, PA-C is a medicare enrolled "Physician Assistant" in Pooler, Georgia. Her current practice location is 200 Blue Moon Xing Ste 203, Pooler, Georgia. You can reach out to her office (for appointments etc.) via phone at (912) 590-0973.

Ms Kerry Kathleen Shuffelbottom is licensed to practice in South Carolina (license number 2131) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1902102676.

Contact Information

Ms Kerry Kathleen Shuffelbottom, PA-C
200 Blue Moon Xing Ste 203,
Pooler, GA 31322-9698
(912) 590-0973
(912) 590-0180

Map and Direction




Provider's Profile

Full NameMs Kerry Kathleen Shuffelbottom
GenderFemale
SpecialityPhysician Assistant
Location200 Blue Moon Xing Ste 203, Pooler, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1902102676
  • Provider Enumeration Date: 01/28/2011
  • Last Update Date: 10/12/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3678754264
  • Enrollment ID: I20180917000061

Medical Identifiers

Medical identifiers for Ms Kerry Kathleen Shuffelbottom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902102676NPI-NPPES
Y06PSOtherFLBCBS
0032613-00MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 2131 (South Carolina)Secondary
363A00000XPhysician Assistant 2131 (South Carolina)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kerry Kathleen Shuffelbottom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Kerry Kathleen Shuffelbottom, PA-C
5191 First Coast Tech Pkwy Fl 3,
Jacksonville, FL 32224-0609

Ph: (904) 223-3321
Ms Kerry Kathleen Shuffelbottom, PA-C
200 Blue Moon Xing Ste 203,
Pooler, GA 31322-9698

Ph: (912) 590-0973

Reviews and Comments


Physician Assistant Nurses in Pooler, GA

Alivia Mcmahan, PA-C
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Practice Location: 6 Holmes Ct, Pooler, GA 31322
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Christopher Robin Alden,
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Phone: 912-737-2250    Fax: 912-355-6914
Beatriz Aponte Bidgood, PA-C
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Practice Location: 17 Marshland Pointe, Pooler, GA 31322
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Grant Westbrook,
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Practice Location: 105 Grand Central Blvd Ste 108, Pooler, GA 31322
Phone: 912-748-1515    
Lauren Embry Lalli, PA
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Medicare: Accepting Medicare Assignments
Practice Location: 135 Canal St Ste 500a, Pooler, GA 31322
Phone: 912-335-3876    
Brian Burkhardt, PA-C
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Medicare: Not Enrolled in Medicare
Practice Location: 107 Canal St, Pooler, GA 31322
Phone: 912-450-1945    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.