Active NPI
Audrey Dorothea Shea
- Other Specialist/Technologist
- Ludlow, MA
National Provider Identifier
1578329207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- 1969
- Practice address
- 356 Sewall St
Ludlow, MA 01056-2850 - Phone
- (413) 544-3856
- NPI assigned
- Feb 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | 1969 | MA | Primary |
Addresses
Primary practice location
356 Sewall St
Ludlow, MA 01056-2850
Mailing address
1 Lincoln PL
Monson, MA 01057-1219
Phone (413) 544-3856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1969 | MA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1578329207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LINCOLN PL",
"city": "MONSON",
"state": "MA",
"postal_code": "010571219",
"telephone_number": "413-544-3856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "356 SEWALL ST",
"city": "LUDLOW",
"state": "MA",
"postal_code": "010562850",
"telephone_number": "413-544-3856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEA",
"first_name": "AUDREY",
"middle_name": "DOROTHEA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-21",
"last_updated": "2024-02-21",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "MA",
"license": "1969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ludlow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.