Individual provider Active NPI

Leeanne E Shaw-Quinn, APRN

  • Gerontology Nurse Practitioner
  • Vernon, CT
National Provider Identifier
1487727228
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
002642 Issued in CT
Practice address
30 Hyde Ave Ste 109
Vernon, CT 06066-4503
Phone
(800) 391-0599
Fax
(980) 825-7196
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 002642 CT Primary

Addresses

Primary practice location

30 Hyde Ave Ste 109
Vernon, CT 06066-4503

Mailing address

30 Jordan LN
Wethersfield, CT 06109-1278
Phone (860) 236-0253

Other identifiers 1

IdentifierTypeStateIssuer
004026424MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lshawquinn59939@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051209000600 CT Practitioner - Nurse Practitioner 3779504436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Housecalls, PLLCGroup PAC ID 4284174228, 17 clinicians

Practice addresses (Care Compare)

30 Lafayette SQ
Suite 30
Vernon, CT 06066-4554
Phone (800) 391-0599

Hospital & facility affiliations

  • Masters in Home Care, LLC Home health agency, Rocky Hill, CT, CCN 077264
  • Vitas Healthcare Corporation Atlantic Hospice, Middlebury, CT, CCN 071533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002642CTMDMental Health Counselor
2642CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC CurrentSince Nov 22, 2017 Accepting new patients
Reliant Housecalls, PLLC CurrentSince Nov 15, 2024 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Nov 22, 2017 Accepting new patients

Locations

30 Lafayette Sq
Ste 30
Vernon, CT 06066
Phone (800) 391-0599

30 Lafayette Sq
Ste 109
Vernon Rockville, CT 06066
Phone (800) 391-0599

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

Interoperability endpoints

  • Direct secure messaging: leeanne.shaw-quinn@637.emedpractice.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1487727228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-236-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HYDE AVE STE 109",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664503",
            "telephone_number": "800-391-0599",
            "fax_number": "980-825-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW-QUINN",
        "first_name": "LEEANNE",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "002642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004026424",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lshawquinn59939@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "30 Hyde Ave Ste 109",
            "city": "Vernon",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060664503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

Verify at the official NPI Registry.