Shannon C Munro, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R049265 Issued in ME

Practice address

37 Palmer St Ste 3
Calais, ME 04619-1341

Phone

(207) 454-8195

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shannon Doughty Former name

Medicare fee-for-service enrollment

Enrolled in ME, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Calais Regional HospitalGroup PAC ID 6901715176, 6 clinicians

Indian Township Tribal GovernmentGroup PAC ID 6103914445, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sunrise County Home Care Services, LLC Home health agency, Lubec, ME, CCN 207051
• Calais Community Hospital Hospital, Calais, ME, CCN 201305
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• Down East Community Hospital Hospital, Machias, ME, CCN 201311

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/calais-879327e9

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.

• Calais Community Hospital

  • Critical Access Hospital
  • Calais, ME
  • NPI 1922001049
  Medicare reassignment Care Compare group NPD
• Indian Township Tribal Government

  • Federally Qualified Health Center (FQHC)
  • Princeton, ME
  • NPI 1205952140

  TX

  Medicare reassignment Care Compare group
• Maine Geriatrics

  • Geriatric Medicine (Internal Medicine) Physician
  • Biddeford, ME
  • NPI 1326156605
  Medicare reassignment
• Calais Community Hospital

  • Rural Health Clinic/Center
  • Baileyville, ME
  • NPI 1467205112
  NPD
• Calais Community Hospital

  • Rural Health Clinic/Center
  • Calais, ME
  • NPI 1134200702
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regional Medical Center at Lubec Inc

  • Home Health Agency
  • Lubec, ME
  • NPI 1417985524
  Care Compare affiliation Name & address match
• Calais Community Hospital

  • Critical Access Hospital
  • Calais, ME
  • NPI 1922001049
  Care Compare affiliation
• Down East Community Hospital

  • Critical Access Hospital
  • Machias, ME
  • NPI 1528087004
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1295828499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PALMER ST STE 3",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191341",
            "telephone_number": "207-454-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 PALMER ST STE 3",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191341",
            "telephone_number": "207-454-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNRO",
        "first_name": "SHANNON",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LS7243",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "AP081371",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R049265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431935199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "DOUGHTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather L. Metcalf, OQMHP
• Jason Michaud, PHARMD
• Kristin A Miller, LMSW-CC
• Nima Moghaddas, DPM
• Marisela Morillo, CRNA
• Brenda A Nadeau Deveau, RN, MHRT-C, LSW
• Laura D Nelson, LMSWCC
• Carina L. Orcutt, O.D.
• Ruth G. Osborne, OQMHP-C-DT
• Jason Palomo

• Family Nurse Practitioner in Calais, ME
• Providers in Calais, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.