Robin Sue Shannon, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2326129 Issued in MA

Practice address

420 Main St Ste 15
Walpole, MA 02081-3753

Phone

(508) 660-1666

Fax

(508) 660-1667

NPI assigned

Mar 6, 2014

Last updated

Oct 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Wellness Connection

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
  • NPI 1144988098
  NPD Authorized official
• Carolina Digestive Health Associates, PA

  dba Carolina Digestive Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1063584415
  NPD (past)

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1518383223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MAIN ST STE 15",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020813753",
            "telephone_number": "508-660-1666",
            "fax_number": "508-660-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MAIN ST STE 15",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020813753",
            "telephone_number": "508-660-1666",
            "fax_number": "508-660-1667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Abelard Psychotherapy Inc",
            "address_2": "450 Pearl St, Suite 3",
            "address_purpose": "LOCATION",
            "city": "Stoughton",
            "state": "MA",
            "postal_code": "02072",
            "country_code": "US",
            "telephone_number": "781-344-0027",
            "fax_number": "781-344-0057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "ROBIN",
        "middle_name": "SUE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006766",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006766",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2326129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518383223",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4339",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Walpole, MA
• Providers in Walpole, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.