Shannon Anne Thompson, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

2341 Issued in MA

Practice address

52 Crest Ave
Winthrop, MA 02152-1064

Phone

(617) 539-0197

Fax

(617) 539-0669

NPI assigned

Feb 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Shannon Anne Connolly Former name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Surgery Physician
  • Boston, MA
  • NPI 1720037385

  Podiatrist

  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Podiatry Healthcare P.C.

  • Foot Surgery Podiatrist
  • Danvers, MA
  • NPI 1669551958
  NPD (past)
• Foot Ankle & Leg Specialists of South Florida Inc

  • Foot & Ankle Surgery Podiatrist
  • Weston, FL
  • NPI 1043269947
  NPD (past)
• Sports Medicine Associates of South Florida, P.a.

  • Orthopaedic Surgery Physician
  • Plantation, FL
  • NPI 1487624771
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1508830548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 CREST AVE",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021521064",
            "telephone_number": "617-539-0197",
            "fax_number": "617-539-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 CREST AVE",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021521064",
            "telephone_number": "617-539-0197",
            "fax_number": "617-539-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SHANNON",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3118",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "2341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110078988A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CONNOLLY",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Sullivan, MS CCC-SLP
• Kelly Jean Swanson
• Syc Wash Inc
• Syoncare Services LLC
• Amanda Vuong Thai
• Lindsay Toutain
• Town of Winthrop
• Town of Winthrop
• Shuk-Kuen Tse, OTR
• Kristen Suzanne Ulrich, M.S., CCC-SLP

• Podiatrist in Winthrop, MA
• Providers in Winthrop, MA by specialty
• Podiatrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.