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Deactivated NPI 1598103111 Deactivated / Inactive NPI Female Practitioner

Shannon Reeves Wallace , PA

Physician Assistant • Chesapeake, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Shannon Wallace has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 05, 2013
NPI Deactivation Date February 06, 2025
Total Practice Duration ~12 Years of Practice (2013 – 2025)

Professional Overview & Biography Verified Profile Summary

Shannon Wallace, PA was a registered Physician Assistant practicing in Chesapeake, VA. Throughout an active medical career spanning 12 years, Shannon Wallace provided care at the practice location at 736 BATTLEFIELD BLVD N until profile deactivation on 2025-02-06.

Historical Medicare Part B clinical services included established patient outpatient office visit, aspiration and/or injection of fluid large joint using ultrasound guidance, injection, methylprednisolone acetate, 40 mg. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

736 Battlefield Blvd N

Chesapeake, VA 233204941

Telephone 7574909388
Fax 7574909401
Associated Practice Facility / Clinic
🏢 Hampton Roads Pathology Inc Facility NPI 1497712756

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Chesapeake, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
119 Specialists

Practicing in Chesapeake, VA (4432 Statewide)

Telehealth Adoption Rate
5.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
80.4% 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 (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
109 69 $239.60 $75.56
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance
77 43 $583.18 $82.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
75 48 $285.53 $104.88
J1030 Injection, methylprednisolone acetate, 40 mg
47 35 $25.89 $5.48
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose
39 20 $298.23 $74.97
J3490 Unclassified drugs
24 22 $15.67 $0.17
73564 X-ray of knee, 4 or more views
15 11 $251.53 $37.44
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle
13 11 $492.69 $49.83

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License VA 0110004256

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.

Practice Associates & Co-Workers

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

21 Associated Practitioners
Sarah Williams , PA

Physician Assistant

NPI 1003625666

Physician Assistant

Jack Witzenfeld , PA

Physician Assistant - Medical

NPI 1093819377

Physician Assistant

Colleen O'leary , PA-C

Physician Assistant

NPI 1144581208

Physician Assistant (Certified)

Evelien Rhodes

Physician Assistant

NPI 1174333793
Dr. Jennifer Salch , DO

Emergency Medicine - Emergency Medical Services

NPI 1184634909

Doctor of Osteopathic Medicine (D.O.)

Erich Salch , PA

Physician Assistant

NPI 1245453091

Physician Assistant

Career & Practice History Timeline

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

12 Historical Events
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NPI Profile Deactivated February 06, 2025

Record deactivated on February 06, 2025

NPI Profile Active November 21, 2017

NPI status registered as active in NPPES database

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Updated Practice Location November 21, 2017

Registered at 5818 D HARBOUR VIEW BLVD, SUITE 150, SUFFOLK, VA 234353327 (Tel: 7572151400)

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Updated Business Mailing Address November 21, 2017

Registered at 5818 D HARBOUR VIEW BLVD, SUITE 150, SUFFOLK, VA 234353327 (Tel: 7572151400)

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Provider Name / Credentials Updated November 21, 2017

Recorded as SHANNON WALLACE, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2017

Physician Assistant

NPI Profile Active June 05, 2013

NPI status registered as active in NPPES database

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Updated Practice Location June 05, 2013

Registered at 736 BATTLEFIELD BLVD N, CHESAPEAKE, VA 233204941 (Tel: 7574909388)

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Updated Business Mailing Address June 05, 2013

Registered at 4536 BONNEY RD, SUITE A, VIRGINIA BEACH, VA 234623818 (Tel: 7574909388)

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Provider Name / Credentials Updated June 05, 2013

Recorded as SHANNON WALLACE, P.A.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2013

Physician Assistant (License #0110004256 in VA)

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Initial NPI Registration & Enumeration June 05, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598103111
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 05, 2013
Last Update: June 05, 2013
Deactivation Date: February 06, 2025

Mailing Address

4536 Bonney Rd, Suite A

Virginia Beach, VA 234623818

Phone: 7574909388

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.