NPIMap

Individual provider Active NPI

Shannon Reddy

  • Family Nurse Practitioner
  • Haverhill, MA
National Provider Identifier
1790462265
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2326805 Issued in MA
Practice address
1 Park Way
Haverhill, MA 01830-6278
Phone
(888) 227-3762
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 091043-23 NH
Family Nurse Practitioner 363LF0000X RN2326805 MA Primary

Addresses

Primary practice location

1 Park Way
Haverhill, MA 01830-6278

Mailing address

149 Brendans Way
Wells, ME 04090-6367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918000890 MA Practitioner - Nurse Practitioner 3274997762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Park Way
Haverhill, MA 01830-6278
Phone (978) 521-3210

2 Corporation Way
Suite 180
Peabody, MA 01960-7996
Phone (978) 532-6111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
091043-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Sep 1, 2023 Accepting new patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Sep 1, 2023 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Mar 21, 2025 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

370 Merrimack St
Bldg 5
Lawrence, MA 01843
Phone (978) 327-2907

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

2 Corporation Way
Ste 180
Peabody, MA 01960
Phone (781) 248-1766

Interoperability endpoints

  • Direct secure messaging: reddy.shannon.nsmc@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1790462265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 BRENDANS WAY",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040906367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK WAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306278",
            "telephone_number": "888-227-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "091043-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2326805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.