Michael D. Shea, APRN-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

002600 Issued in CT

Practice address

339 West Main St.
Hartford Healthcare Medical Medical Group
Avon, CT 06001

Phone

(860) 696-2150

Fax

(860) 696-2160

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hartford Healthcare Medical Group, Inc

  dba Hartford HealthCare Medical Group

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301

  Nurse Practitioner

  Medicare reassignment NPD
• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment NPD

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1447371596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 WEST MAIN ST.",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-696-2150",
            "fax_number": "860-696-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 WEST MAIN ST.",
            "address_2": "HARTFORD HEALTHCARE MEDICAL MEDICAL GROUP",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-696-2150",
            "fax_number": "860-696-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "002600",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ted Scott Sewitch, PHD CLINICAL PSYCHOL
• Pari Shah, OD
• Jill D Shalan, PH.D. CLINICAL PSYCH
• Eileen Sharp, APRN
• Marilyn Sharpe, OTR
• Lisa Sheehan, PA-C
• Duojia Shen, APRN
• Selinda A Shepherd, DPT
• Michael James Shiembob, OD
• Salli Unhong Shon, LCSW, BCBA, LBA

• Nurse Practitioner in Avon, CT
• Providers in Avon, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.