Shannon Craft
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Portsmouth, RI
NPI 1174875132 · NPPES record last updated Mar 27, 2023
Key facts
- NPI
- 1174875132
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN02272 (RI)
- Practice address
- 107 Clock Tower SQ
Portsmouth, RI 02871-1396 - Phone
- (401) 293-5930
- Fax
- (401) 293-0097
- NPI assigned
- Oct 15, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
387 Quarry St
Suite 100
Fall River, MA 02723-1025
387 Quarry St
Suite 100
Fall River, MA 02723-1026
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250818000443 | MA | Practitioner - Nurse Practitioner | 8224537212 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2269687 | MA | MD | Registered Nurse |
| APRN02272 | RI | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthfirst Family Care Center Inc. | Current |
Accepting new patients | |
| Compass Rose Psychiatry, LLC | Past |
Accepting new patients |
Locations
387 Quarry St
Ste 100
Fall River, MA 02723
Phone (508) 679-8111
Interoperability endpoints
- scraft51254@direct.ctc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2269687 | MA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN02272 | RI | Yes |
Addresses
Primary practice location
107 Clock Tower SQ
Portsmouth, RI 02871-1396
Mailing address
107 Clock Tower SQ
Portsmouth, RI 02871-1396
Phone (401) 293-5930
Other practice location 1
200 Mill Rd
Fairhaven, MA 02719-5252
Phone (508) 973-3200
Other practice location 2
874 Purchase St
New Bedford, MA 02740-6232
Phone (508) 992-6553
Other providers in Portsmouth, RI
- Brandi Sue Colesanti
- Comfort Zone Shoes and Footbeds LLC
- Compass Rose Psychiatry, LLC
- Tanja M. Conroy
- Susan Heather Cosimini I
- Caitlin Curis
- Bowen R Daileader
- David a. Johnson DO, Inc
- Bok Nam De Gregorio
- Deborah Winthrop Fine Lingerie and Gifts
All providers in Portsmouth, RI · Psychiatric/Mental Health Nurse Practitioner in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.