Individual provider Active NPI

Shannon R Healy, N.P.

  • Family Nurse Practitioner
  • Chelsea, MA
National Provider Identifier
1093067688
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN277208 Issued in MA
Practice address
1000 Broadway
Chelsea, MA 02150-2247
Phone
(617) 975-6200
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN277208 MA Primary

Addresses

Primary practice location

1000 Broadway
Chelsea, MA 02150-2247

Mailing address

602 E 2ND St
Unit C
Boston, MA 02127-1513
Phone (508) 863-1344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130109000260 MA Practitioner - Nurse Practitioner 9537312269 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

93 Pond St
Sharon, MA 02067-2015
Phone (781) 784-9212

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN277208MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 1, 2012 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Nov 1, 2012 Accepting new patients
Medical Care of Boston Management Corporation CurrentSince Jan 27, 2014 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 1, 2012 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Nov 1, 2012 Accepting new patients
Jordan Physician Associates, Inc. Family Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1000 Broadway
Chelsea, MA 02150
Phone (617) 660-6600

6 Greenside Way S
Ste 1
Plymouth, MA 02360

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

  • Direct secure messaging: shealy459912@direct.bilh.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1093067688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E 2ND ST",
            "address_2": "UNIT C",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021271513",
            "telephone_number": "508-863-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502247",
            "telephone_number": "617-975-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEALY",
        "first_name": "SHANNON",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN277208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.