Individual provider Active NPI

Laurie Shean, RN NP

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1184776015
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
158667 Issued in MA
Practice address
15 Parkman St
605
Boston, MA 02114-3117
Phone
(617) 726-7930
Fax
(617) 724-0331
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 158667 MA Primary

Addresses

Primary practice location

15 Parkman St
605
Boston, MA 02114-3117

Mailing address

42 Wedgemere Ave
Winchester, MA 01890-2441

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
I20060213000452 MA Practitioner - Nurse Practitioner 1355356353 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158667MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 1, 2017 Accepting new patients
The General Hospital Corporation CurrentSince Jan 1, 2017 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

15 Parkman St
#605
Boston, MA 02114
Phone (617) 724-8400

55 Fruit St
Boston, MA 02114

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184776015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 WEDGEMERE AVE",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018902441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "address_2": "605",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "617-726-7930",
            "fax_number": "617-724-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAN",
        "first_name": "LAURIE",
        "credential": "RN NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "158667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.