Shannon Fraser

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

33 William St Apt 4C
Mount Vernon, NY 10552-2843

Phone

(646) 623-7680

NPI assigned

Apr 16, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1619763737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WILLIAM ST APT 4C",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105522843",
            "telephone_number": "646-623-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WILLIAM ST APT 4C",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105522843",
            "telephone_number": "646-623-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Fox, PSY.D.
• Eleanor Francis-Mitchell, LPN
• Cheyenne Franklin, R.N.
• Tanasha Nicole Franklin
• Kerri-Ann L Fraser-Aitkens, LPN
• Phalguni Freeman
• Luciana O. Freitas, LMSW
• Esti Freud
• Full Grace Physical Therapy, PC
• Fulton Therapy Services PC

• Early Intervention Provider Agency in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.