Shaun Charles Spanos, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN255779 Issued in MA

Practice address

29 Albion St Ste 4B
Wakefield, MA 01880-2801

Phone

(781) 314-0002

NPI assigned

Apr 15, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vibrant Minds and Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wakefield, MA
  • NPI 1083478721
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1003660150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WINTER ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033271",
            "telephone_number": "978-866-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 ALBION ST STE 4B",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802801",
            "telephone_number": "781-314-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANOS",
        "first_name": "SHAUN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN255779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Smukler
• Jessica Wei Soper
• Mary Soraghan Ingemi
• Ashley Sousa
• Elizabeth Anne Spanner, BCBA
• Specialized Autism Consultants
• Speech Together LLC
• Jill Ann Speed
• Lindsey Van Houten Spratt, LMHC
• Starboard Medical LLC

• Psychiatric/Mental Health Nurse Practitioner in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.