Individual provider Active NPI

Shannon Nicole Baker, FNP-BC

  • Family Nurse Practitioner
  • Greenfield, MA
National Provider Identifier
1104412535
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2298153 Issued in MA
Practice address
102 Main St
Greenfield, MA 01301-3275
Phone
(413) 325-8500
NPI assigned
Dec 20, 2020
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Critical Care Medicine Registered Nurse 163WC0200X RN2298153 MA
Family Nurse Practitioner 363LF0000X RN2298153 MA Primary

Addresses

Primary practice location

102 Main St
Greenfield, MA 01301-3275

Mailing address

97 Locust St
Northampton, MA 01060-2054

Other practice location 1

575 Beech St
Holyoke, MA 01040-2223
Phone (413) 534-2516

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
I20220111000971 MA Practitioner - Nurse Practitioner 9830581420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 Main St
Greenfield, MA 01301-3275
Phone 4133258500109

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2298153MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Franklin County Incorporated CurrentSince Oct 6, 2021 Accepting new patients
Community Health Center of Franklin County Incorporated Current Accepting new patients
Community Health Center of Franklin County Incorporated CurrentSince Oct 6, 2021 Accepting new patients
Community Health Center of Franklin County Incorporated Past Accepting new patients

Locations

102 Main St
Greenfield, MA 01301
Phone (413) 325-8500

119 New Athol Rd
Orange, MA 01364
Phone (978) 249-9033

8 Burnham St
Turners Falls, MA 01376
Phone (413) 774-3751

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1104412535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MAIN ST",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013013275",
            "telephone_number": "413-325-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 Beech St",
            "address_purpose": "LOCATION",
            "city": "Holyoke",
            "state": "MA",
            "postal_code": "010402223",
            "country_code": "US",
            "telephone_number": "413-534-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MA",
            "license": "RN2298153",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2298153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, MA

Sources for this page

Verify at the official NPI Registry.