Shannon R Grove, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2299385 Issued in MA

Practice address

10 Centennial Dr Ste 104
Peabody, MA 01960-2298

Phone

(978) 535-1110

Fax

(978) 535-2907

NPI assigned

Sep 1, 2016

Last updated

Jun 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgrove33527@direct.chppoc.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New England Center for Mental Health LLC

  dba New England Center for Mental Healthy Minds

  • Mental Health Counselor
  • Acton, MA
  • NPI 1346560083
  Medicare reassignment NPD
• Pediatric Health Care Associates PC

  • Pediatrics Physician
  • Peabody, MA
  • NPI 1821153180
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1396292892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTENNIAL DR STE 104",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602298",
            "telephone_number": "978-535-1110",
            "fax_number": "978-535-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTENNIAL DR STE 104",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602298",
            "telephone_number": "978-535-1110",
            "fax_number": "978-535-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "SHANNON",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2299385",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2299385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020860",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carissa Grevengoed, M.S., CCC-SLP
• Bonnie Griffin
• Elysia Griswold, MD
• Julia Michelle Grober
• Gross Young Enterprises, Inc (Leni Gross Young, MA, LMHC)
• Dana Thomas Guarino, PA-C
• Anna Mei Gubbins
• Yazmin Guevara Alvarez, M.ED
• Kathleen M Guicho, NP
• Jessica Guillen

• Psychiatric/Mental Health Nurse Practitioner in Peabody, MA
• Providers in Peabody, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.