Shawsheen Medical Asso PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SHAWSHEEN MEDICAL ASSO PC

Practice address

28 Andover St
Andover, MA 01810

Phone

(978) 475-8989

Fax

(978) 475-8886

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Suetta Tenney, MD

Title

President Owner

Phone

(978) 475-8886

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891861175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ANDOVER ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-475-8989",
            "fax_number": "978-475-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ANDOVER ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-475-8989",
            "fax_number": "978-475-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWSHEEN MEDICAL ASSO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TENNEY",
        "authorized_official_first_name": "SUETTA",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "978-475-8886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FULLON",
            "identifier": "54177",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "C0193",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9711180",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M17815",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NH",
            "identifier": "SHAW119181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Elaine Sgrosso, OTR
• Howard Jeffrey Shaffer, PH.D.
• Samir S Shah, DO
• Steven R. Shank, M.A., LMHC
• Apara Sharma, DMD
• Ashley I Sheehan
• Karyn Lynn Sheehan, LICSW
• Maureen Sheehy, LICSW
• Melanie Lynn Shipon, M.ED
• Cynthia Shuttleton, PHD

• Internal Medicine Physician in Andover, MA
• Providers in Andover, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.