Individual provider Active NPI

Mark Shannon, M.D.

  • Internal Medicine Physician
  • Barrington, RI
National Provider Identifier
1508941089
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD7250 Issued in RI
Practice address
42 Lincoln Ave
Barrington, RI 02806-2136
Phone
(401) 246-0389
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD7250 RI Primary

Addresses

Primary practice location

42 Lincoln Ave
Barrington, RI 02806-2136

Mailing address

42 Lincoln Ave
Barrington, RI 02806-2136
Phone (401) 246-0389

Other practice location 1

2090 Wallum Lake Rd
Pascoag, RI 02859-1813
Phone (401) 567-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081113000039 RI Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7517026099 Reassigns benefits to 1 organization
Practice locations: Barrington, RI

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD7250RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jun 1, 2014 Accepting new patients
Prospect Chartercare Sjhsri, LLC Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients

Locations

2 Wake Robin Rd
Lincoln, RI 02865
Phone (401) 333-1747

200 High Service Ave
#3
North Providence, RI 02904
Phone (401) 456-3649

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

21 Peace St
Providence, RI 02907
Phone (401) 456-3000

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1508941089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 LINCOLN AVE",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028062136",
            "telephone_number": "401-246-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 LINCOLN AVE",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028062136",
            "telephone_number": "401-246-0389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2090 Wallum Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Pascoag",
            "state": "RI",
            "postal_code": "028591813",
            "country_code": "US",
            "telephone_number": "401-567-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD7250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, RI

Sources for this page

Verify at the official NPI Registry.