Individual provider Active NPI

Shannon Kay, PH.D., BCBA-D

  • Psychologist
  • Springfield, MA
National Provider Identifier
1487907754
Registry record updated Feb 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
9164 Issued in MA
Practice address
50 Wason Ave
1St FL
Springfield, MA 01199-1619
Phone
(413) 794-4160
Fax
(413) 794-4884
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 9164 MA Primary

Addresses

Primary practice location

50 Wason Ave
1St FL
Springfield, MA 01199-1619

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1619
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131218001399 MA Practitioner - Clinical Psychologist 5294962247 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9164MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Center Inc CurrentSince Jul 1, 2016 Accepting new patients
Baystate Medical Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients

Locations

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

50 Wason Ave
Fl 1
Springfield, MA 01107
Phone (413) 794-5437

50 Wason Ave
Springfield, MA 01107
Phone (413) 794-2515

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.

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424476800000",
    "number": "1487907754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991619",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 WASON AVE",
            "address_2": "1ST FL",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991619",
            "telephone_number": "413-794-4160",
            "fax_number": "413-794-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAY",
        "first_name": "SHANNON",
        "credential": "PH.D., BCBA-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2015-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "9164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.