Active NPI
Shannon Lynn Henning, D.O.
- Pediatrics Physician
- Syosset, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0102207238
- Practice address
- 596 Jericho Tpke
Syosset, NY 11791-4522 - Phone
- (516) 677-5437
- NPI assigned
- Jul 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 263677 | NY | |
| Pediatrics Physician | 208000000X | 0102207238 | VA | Primary |
Addresses
Primary practice location
596 Jericho Tpke
Syosset, NY 11791-4522
Mailing address
13135 Lee Jackson Hwy Ste 201
Fairfax, VA 22033-1907
Phone (812) 322-3108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 263677 | NY | MD | Pediatrics Physician |
| 0102207238 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Island Emergency Medical Services, P.C. | Current | Accepting new patients | |
| Kim Medical of New York PLLC | Current | Accepting new patients | |
| Flushing Hospital Medical Center | Current | Accepting new patients | |
| Flushing Hospital & Medical Center | Current | Accepting new patients | |
| Hello Pediatrics Medicine PLLC | Pediatrics | Past | Accepting new patients |
Locations
4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631
14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562
255 Executive Dr
Ste 210B
Plainview, NY 11803
Phone (516) 687-9563
10 Maple St
Prt Washingtn, NY 11050
Phone (917) 746-5942
50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225
Interoperability endpoints
- shannon.henning@hellopeds.eclinicaldirectplus.com
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Flushing, NY
- NPI 1548217763
-
- Emergency Medicine Physician
- Far Rockaway, NY
- NPI 1639160385
-
- Primary Care Clinic/Center
- Plainview, NY
- NPI 1770230039
-
- Skilled Nursing Facility
- Flushing, NY
- NPI 1568693174
-
- Pediatrics Physician
- Hicksville, NY
- NPI 1407639198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1194037333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13135 LEE JACKSON HWY STE 201",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331907",
"telephone_number": "812-322-3108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "596 JERICHO TPKE",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914522",
"telephone_number": "516-677-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNING",
"first_name": "SHANNON",
"middle_name": "LYNN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-03",
"last_updated": "2022-05-20",
"certification_date": "2022-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "263677",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0102207238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.