MEDICARE: AUSTIN SHANDLEY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	00000000	MO

General Provider Information

NPI Number	:	1881085066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN SHANDLEY PA

Provider Business Mailing Address
First Line	:	1419 VILLAGE DR
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-2459
Country	:	US
Telephone Number	:	816-364-1507
Fax Number	:

Provider Business Practice Location Address
First Line	:	8656 N AMBASSADOR DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64154-2558
Country	:	US
Telephone Number	:	816-584-8100
Fax Number	:	816-584-8106

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2015
Last Update Date	:	03/13/2025

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Directions to “ AUSTIN SHANDLEY PA” Practice Location

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