Shannon M. Bennett, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO2387 Issued in ME

Practice address

22 Bramhall St
Portland, ME 04102-3134

Phone

(207) 662-2541

NPI assigned

Mar 31, 2009

Last updated

Jun 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  dba Maine Medical Partners Neurology

  • Neurology Physician
  • Scarborough, ME
  • NPI 1497052518
  NPD
• Mainehealth

  dba MaineHealth Maine Medical Center

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1760436216
  NPD (past)

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1881836203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 HOLMES RD",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040729364",
            "telephone_number": "207-604-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "SHANNON",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "DO2387",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "DO2387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Kathleen Bennett, CRNA
• Kathleen E Bennett, M.S., CF -SLP
• Mary Bennett, LCSW
• Michael Bennett, DMD
• Robert Bennett Jr., LCSW
• Theresa L Bennett, LCSW
• Tracy W Bennett, LCPC
• David Arthur Benoit Sr., CADC
• Lynne A Benoit
• Suzanne V Benoit, LCSW

• Pediatrics Physician in Portland, ME
• Providers in Portland, ME by specialty
• Pediatrics Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.