Individual provider Active NPI

Tennie Margaret Shardlow, PA-C

  • Physician Assistant
  • Augusta, ME
National Provider Identifier
1811402860
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
37 Gray Birch Dr
Augusta, ME 04330-6105
Phone
(207) 626-1000
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

37 Gray Birch Dr
Augusta, ME 04330-6105

Mailing address

183 Gray Rd
North Yarmouth, ME 04097-6009
Phone (207) 441-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180330000498 ME Practitioner - Physician Assistant 0941562037 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

730 Ctr St
Suite 9
Auburn, ME 04210-6316
Phone (207) 783-3450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA368MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rumford Hospital CurrentSince Jul 26, 2011 Accepting new patients
Bridgton Hospital CurrentSince Jul 26, 2022 Accepting new patients
Mainegeneral Medical Center CurrentSince Dec 18, 2017 Accepting new patients
Central Maine Medical Center CurrentSince Jul 26, 2022 Accepting new patients
Central Maine Medical Center CurrentSince Jul 26, 2022 Accepting new patients
Mainegeneral Medical Center CurrentSince Dec 18, 2017 Accepting new patients

Locations

37 Gray Birch Dr
Augusta, ME 04330
Phone (207) 621-7100

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 8

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 2

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": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1811402860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 GRAY RD",
            "city": "NORTH YARMOUTH",
            "state": "ME",
            "postal_code": "040976009",
            "telephone_number": "207-441-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 GRAY BIRCH DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306105",
            "telephone_number": "207-626-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARDLOW",
        "first_name": "TENNIE",
        "middle_name": "MARGARET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.