Individual provider Active NPI

Shawn V. Hennessy, NP-C

  • Family Nurse Practitioner
  • Falmouth, MA
National Provider Identifier
1679952238
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2291166 Issued in MA
Practice address
100 Ter Heun Dr
Falmouth, MA 02540
Phone
(508) 457-3660
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2291166 MA
Family Nurse Practitioner 363LF0000X RN2291166 MA Primary

Addresses

Primary practice location

100 Ter Heun Dr
Falmouth, MA 02540

Mailing address

100 Ter Heun Dr
Falmouth, MA 02540-2503
Phone (508) 457-3660

Other practice location 1

525 Long Pond Dr
Harwich, MA 02645-1227
Phone (508) 432-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150806010872 MA Practitioner - Nurse Practitioner 7911211743 Reassigns benefits to 2 organizations
I20210830002298 ME Practitioner - Nurse Practitioner 7911211743

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.11 of 100Reported as group
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2291166MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Urgi Center Medical Group CurrentSince Jan 25, 2016 Accepting new patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

100 Ter Heun Dr
Falmouth, MA 02540
Phone (508) 457-3501

525 Long Pond Dr
Harwich, MA 02645
Phone (508) 430-3311

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

2 Jan Sebastian Dr
Sandwich, MA 02563
Phone (508) 833-8247

2 Jan Sebastian Dr
Ste 101
Sandwich, MA 02563
Phone (508) 833-2639

273 Teaticket Hwy
Teaticket, MA 02536
Phone (508) 495-8000

Organizations & group practices 4

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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1679952238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TER HEUN DR",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402503",
            "telephone_number": "508-457-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TER HEUN DR",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "02540",
            "telephone_number": "508-457-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Long Pond Dr",
            "address_purpose": "LOCATION",
            "city": "Harwich",
            "state": "MA",
            "postal_code": "026451227",
            "country_code": "US",
            "telephone_number": "508-432-4100",
            "fax_number": "508-432-8951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "SHAWN",
        "middle_name": "V.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2291166",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2291166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, MA

Sources for this page

Verify at the official NPI Registry.