Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902102676 Individual Practitioner Female Practitioner

Kerry Kathleen Shuffelbottom , PA-C

Physician Assistant • Pooler, GA

Professional Overview & Biography Verified Profile Summary

Kerry Shuffelbottom, PA-C is a registered healthcare professional specializing in Physician Assistant in Pooler, GA. Practice services are available at 200 BLUE MOON XING STE 203 under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, testing for presence of drug, by chemistry analyzers, 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. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

200 Blue Moon Xing Ste 203

Pooler, GA 313229698

Telephone 9125900973
Fax 9125900180
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Pooler, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.8 Yrs
State Avg: 12.9 Yrs
Regional Practice Density
14 Specialists

Practicing in Pooler, GA (4726 Statewide)

Telehealth Adoption Rate
7.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
80.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
200 132 $500.21 $99.14
80307 Testing for presence of drug, by chemistry analyzers
36 35 $249.00 $60.90
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
35 34 $988.94 $241.98
99213 Established patient office or other outpatient visit, typically 15 minutes
33 29 $354.15 $70.24
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes
28 28 $753.77 $106.89
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes
26 16 $524.77 $86.05

Medical Specialties & State Licenses

CMS Verified: 2023-10-12
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License SC 2131

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.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License SC 2131

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0032613-00 (FL)
Commercial Insurance / Payer ID Bcbs
Y06PS (FL)

Secondary Practice Locations

3408 Trout St

Brunswick, GA 315203622

Phone: 9125900973

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Kimberly Cecil , PA

Physician Assistant

NPI 1124791405

Physician Assistant

Salaethia Crawford

Nurse Practitioner - Family

NPI 1144699943
Dr. Chirag Patel , MD

Pain Medicine - Interventional Pain Medicine

NPI 1154548071

Doctor of Medicine (M.D.)

Mallory Chiang

Physician Assistant

NPI 1174387773
Dr. Guensley Delva , MD

Pain Medicine - Interventional Pain Medicine

NPI 1285019018

Doctor of Medicine (M.D.)

Janna Moody , APRN

Nurse Practitioner - Family

NPI 1467085217

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location October 12, 2023

Registered at 200 BLUE MOON XING STE 203, POOLER, GA 313229698 (Tel: 9125900973)

📍
Updated Business Mailing Address October 12, 2023

Registered at 5191 FIRST COAST TECH PKWY FL 3, JACKSONVILLE, FL 322240609 (Tel: 9042233321)

📍
Updated Practice Location May 05, 2022

Registered at 604 W OGLETHORPE HWY, HINESVILLE, GA 313134415 (Tel: 9129103777)

📍
Updated Business Mailing Address May 05, 2022

Registered at 106 DAISY CT, SAVANNAH, GA 314041886 (Tel: 8432602492)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 05, 2022

Physician Assistant (License #2131 in SC)

NPI Profile Active May 09, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location May 09, 2016

Registered at 2418 NNPTC CIRCLE, GOOSE CREEK, SC 29445 (Tel: 8435775011)

📍
Updated Business Mailing Address May 09, 2016

Registered at 2418 NNPTC CIRCLE, GOOSE CREEK, SC 29445 (Tel: 8435775011)

👤
Provider Name / Credentials Updated May 09, 2016

Recorded as KERRY SHUFFELBOTTOM, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 09, 2016

Physician Assistant (License #2131 in SC)

🟢
Initial NPI Registration & Enumeration January 28, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1902102676
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 28, 2011
Last Update: October 12, 2023
Sole Proprietor: No

Mailing Address

5191 First Coast Tech Pkwy Fl 3

Jacksonville, FL 322240609

Phone: 9042233321

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.