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KATHLEEN SHANNON PA-C
NPI 1407954357
Physician Assistant - Medical in Brockton, MA

Active since September 21, 2006PECOS Enrolled
940 BELMONT ST, VA BOSTON HEALTHCARE SYSTEM, BROCKTON, MA 02301(508) 583-4500 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kathleen Shannon Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN SHANNON PA-C (NPI 1407954357) is an individual medical provider in Brockton, Massachusetts, licensed in Massachusetts (894) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407954357
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKATHLEEN SHANNONCredential: PA-C
Location Address940 BELMONT ST, VA BOSTON HEALTHCARE SYSTEMBrockton, MA 02301-5596
Mailing Address9 Martha AveSwansea, MA 02777-1617 · (508) 675-7708
Phone(508) 583-4500
Sole ProprietorNo
Enumeration DateSeptember 21, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1407954357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MA · 894
940 BELMONT ST, Brockton, MA 02301
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen Shannon Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIN ELIZABETH SULLIVAN
Social Worker (Clinical)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
DR. JENI ELAINE NORSTROM PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (774) 826-2188
JOSEPH KEENE
Licensed Practical Nurse
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (774) 826-2160
MRS. ROBIN PARENTE R.N.
Registered Nurse (Critical Care Medicine)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (774) 826-1194
DANIELLE NIXON LCSW
Case Manager/Care Coordinator
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
ANAIS LUGO-GUERCIO
Occupational Therapist
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
MRS. TRUDY ROSE RADVILLE OTR/L
Occupational Therapist
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
DR. PEGGY MENTOR MD
Family Medicine (Geriatric Medicine)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (857) 364-4418

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Shannon's NPI number?

The NPI number for Kathleen Shannon is 1407954357. It was assigned to this individual provider in the NPPES registry on September 21, 2006.

Where is Kathleen Shannon located?

Kathleen Shannon practices at 940 Belmont St VA Boston Healthcare System, Brockton, MA 02301. The listed phone number is (508) 583-4500.

What is Kathleen Shannon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kathleen Shannon enrolled in Medicare?

Yes. Kathleen Shannon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kathleen Shannon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.