Individual provider Active NPI

Shannon Beck

  • Nurse Practitioner
  • Medway, MA
National Provider Identifier
1114536463
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN274440 Issued in MA
Practice address
7 Autumn Rd
Medway, MA 02053-2153
Phone
(508) 397-3486
NPI assigned
Jul 23, 2020
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN274440 MA Primary

Addresses

Primary practice location

7 Autumn Rd
Medway, MA 02053-2153

Mailing address

7 Autumn Rd
Medway, MA 02053-2153
Phone (508) 397-3486

Other practice location 1

55 Fruit St
Boston, MA 02114-2621
Phone (508) 397-3486

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
I20211124000056 MA Practitioner - Nurse Practitioner 7214327733 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vantage Healthcare LLCGroup PAC ID 8224361191, 72 clinicians

Practice addresses (Care Compare)

45 Dan Rd
Canton, MA 02021-2852
Phone (781) 867-2050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Healthcare LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

95 Commercial St
Braintree, MA 02184
Phone (781) 848-0596

45 Dan Rd
Canton, MA 02021
Phone (781) 318-3609

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1114536463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 AUTUMN RD",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020532153",
            "telephone_number": "508-397-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 AUTUMN RD",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020532153",
            "telephone_number": "508-397-3486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "508-397-3486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECK",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN274440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medway, MA

Sources for this page

Verify at the official NPI Registry.