Shannon Kearney

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

315861-1 Issued in NY

Practice address

30 Buccaneer LN
East Setauket, NY 11733-1863

Phone

(631) 675-0369

NPI assigned

Oct 29, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Mary Covino Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477699200000",
    "number": "1386196988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BUCCANEER LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331863",
            "telephone_number": "631-675-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BUCCANEER LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331863",
            "telephone_number": "631-675-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-29",
        "last_updated": "2016-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "315861-1",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "34308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "COVINO",
            "middle_name": "MARY",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen a Bowen NP of Psychiatry PC.
• Svetlana Katsnelson, MD
• Arnold Katz, M.D.
• Tara Kaufmann, M.D.
• Christopher Kearney, PSY.D
• Roger B Keizerstein, LCSW
• Kathleen Kelly Lyon, NP
• Gerald Kelly, D.O.
• Rita Marie Kelly, NP
• Jennifer Lynn Keluskar

• Licensed Practical Nurse in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.