MRS. SHANNON M. WIDDERICK PA-C
NPI 1942482914
Physician Assistant in Northampton, MA

Q: What is Shannon Widderick's NPI number?

The NPI number for Shannon Widderick is 1942482914. It was assigned to this individual provider in the NPPES registry on December 3, 2007.

Q: What is Shannon Widderick's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Widderick was last updated on January 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since December 03, 2007

395 PLEASANT ST, NORTHAMPTON, MA 01060(413) 584-7787(413) 584-7778 Get Directions Write a Review

NPPES record last updated: January 2, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Shannon M. Widderick Pa-c NPPES

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

MRS. SHANNON M. WIDDERICK PA-C (NPI 1942482914) is an individual physician assistant in Northampton, Massachusetts, licensed in Massachusetts (PA2360) and active in the NPI registry since December 2007.

NPPES Registry Identity

NPI1942482914

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. SHANNON M. WIDDERICKCredential: PA-C

Location Address395 PLEASANT STNorthampton, MA 01060-3914

Mailing Address395 Pleasant StNorthampton, MA 01060-3914 · (413) 584-7787 · Fax (413) 584-7778

Phone(413) 584-7787

Fax(413) 584-7778

Sole ProprietorNo

Enumeration DateDecember 3, 2007

Last NPPES UpdateJanuary 2, 2013

✔ NPI 1942482914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in MA · PA2360✔ Licensed in MA · 2360✔ Licensed in CT · 001992

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

395 PLEASANT ST, Northampton, MA 01060

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Other Identifiers 3

Medicare PIN00000000MA

Medicaid003019924CT

Medicare PIN970002640 (C00814)CT

Other Providers at the Same Location NPPES 13

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

ERIN BALDWIN FNP-C

Family Medicine