Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON MICHELLE ROOT BAST, PA
Active Sole ProprietorSHANNON MICHELLE ROOT BAST, PA is a Physician Assistant healthcare provider located in BRIDGETON, Missouri. NPI 1760946669 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · BRIDGETON, MO
Registration Details
- NPI Number
- 1760946669
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 24, 2019 (7.5203296521898 yrs)
- Last Updated
- Mar 6, 2026
- License
-
2020023147 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12266 DE PAUL DR STE 205BRIDGETON, MO, 630442514Browse MO providers · Browse ZIP 63044
- Phone
- 3142182300
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in BRIDGETON, MO
| Name | Credential | NPI |
|---|---|---|
| ANDREW J WAHLE | PA | 1306828819 |
| PAUL J DIESFELD | PA-C | 1396796041 |
| MRS. LYNN M ROBBINS | PA-C | 1356393961 |
| KIMBERLY L. LUU | PA | 1669553590 |
| MICHELE L BENA | PA-C | 1720127012 |
| MRS. AMBER RENEE JOHNSON | PAC MMS | 1275706913 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.