Active NPI
Shannon Lindsay Terkell, M.D.
- Child & Adolescent Psychiatry Physician
- Riverside, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD14752
- Practice address
- 1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061 - Phone
- (401) 432-1000
- Fax
- (401) 432-1500
- NPI assigned
- Aug 2, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD14752 | RI | Primary |
Addresses
Primary practice location
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Mailing address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151009001248 | RI | Practitioner - Psychiatry | 1052530334 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lifespan Physician Group Inc
Practice addresses (Care Compare)
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD14752 | RI | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group, Inc. | Child & Adolescent Psychiatry | Current | Accepting new patients |
| Lifespan Corporation | Current | Accepting new patients | |
| Gateway Healthcare Inc | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Emma Pendleton Bradley Hospital | Past | Accepting new patients |
Locations
1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829
105 Bacon St
Pawtucket, RI 02860
Phone (401) 722-3560
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
1 Virginia Ave
Ste 200
Providence, RI 02905
593 Eddy St
Providence, RI 02903
1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000
Interoperability endpoints
- sterkell17030@brownhealth.medalliesdirect.net
Organizations & group practices 8
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.
-
- Psychiatry Physician
- Providence, RI
- NPI 1548506793
Child & Adolescent Psychiatry, RI
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
RI
-
- Anesthesiology Physician
- Providence, RI
- NPI 1053782466
-
- Urgent Care Clinic/Center
- Warwick, RI
- NPI 1285191163
-
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
- Children's Rehabilitation Hospital
- Providence, RI
- NPI 1790221232
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
-
- Psychiatry Physician
- Riverside, RI
- NPI 1073705943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1386958346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 VETERANS MEMORIAL PKWY",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029155061",
"telephone_number": "401-432-1000",
"fax_number": "401-432-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 VETERANS MEMORIAL PKWY",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029155061",
"telephone_number": "401-432-1000",
"fax_number": "401-432-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERKELL",
"first_name": "SHANNON",
"middle_name": "LINDSAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-02",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "RI",
"license": "MD14752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.