SHANNON MARIE MEREDITH (NPI# 1407897614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407897614 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE MEREDITH |
| Credential | DPM |
| Practice Address |
195 Fore River Pkwy Suite 210 Portland ME 04102-2780 |
| Mailing Address |
144 State St Portland ME 04101-3776 |
| Practice Telephone | 2075536682 |
| Practice Fax Number | 2075536681 |
| Mailing Telephone | 2078793000 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2008-08-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 1000 | ME | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | AETNA | 104104 | 01 |
| FEDERAL BLUE SHIELD | 14284 | 01 | |
| ME | HARVARD PILGRIM | U47765 | 01 |
| ME | MARTINS POINT | 001299 | 01 |
| ME | ANTHEM BLUE CROSS | 014284 | 01 |
| DEPT OF LABOR | 100429800 | 01 | |
| ME | 127440000 | 05 | |
| ME | RAILROAD MEDICARE | 480016606 | 01 |
| Street Address |
195 FORE RIVER PKWY SUITE 210 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104822709 | Nena G Ragay-lundkvist | Family Medicine | 195 Fore River Pkwy, Suite 160, Portland, ME 04102-2780 | 2005-06-28 |
| 1952767790 | Debra Lynn Pelletier Webb | Speech-Language Pathologist | 195 Fore River Pkwy, Portland, ME 04102-2780 | 2016-01-09 |
| 1669879680 | Ginny Crockett-maillet | Nurse Practitioner | 195 Fore River Pkwy, Suite 360, Portland, ME 04102-2780 | 2014-11-20 |
| 1427313048 | Mercy Hospital | General Acute Care Hospital | 195 Fore River Pkwy, Suite 300, Portland, ME 04102-2780 | 2012-07-10 |
| 1285995514 | Katherine S Ozarowski | Pediatrics | 195 Fore River Pkwy, Suite 160, Portland, ME 04102-2780 | 2012-06-04 |
| 1376817023 | Verne Weisberg | Plastic Surgery | 195 Fore River Pkwy, Suite 140, Portland, ME 04102-2780 | 2012-02-28 |
| 1740559236 | Ali Abbasian Hersini | Orthopaedic Surgery | 195 Fore River Pkwy, Suite 210, Portland, ME 04102-2780 | 2011-12-29 |
| 1437440278 | Jessica Ann Faught | Orthopaedic Surgery | 195 Fore River Pkwy, Suire 210, Portland, ME 04102-2780 | 2011-04-27 |
| 1407178858 | Susan Rae Baskin | Pediatrics | 195 Fore River Pkwy, Suite 150, Portland, ME 04102-2780 | 2010-02-25 |
| 1699917898 | Kristy Perkowski | Pediatrics | 195 Fore River Pkwy, Suite 160, Portland, ME 04102-2780 | 2009-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033560867 | John M Barnes Dpm LLC | Podiatrist | 9615 Nw Randall Ln, Portland, OR 97229-5294 | 2016-06-22 |
| 1619338829 | Cara Beach | Podiatrist | 9900 Sw Hall Blvd Ste 100, Portland, OR 97223-5838 | 2016-03-15 |
| 1265743090 | Nanjin Jasmine Park | Podiatrist | 5311 Sw Baird St, Portland, OR 97219-5023 | 2010-06-26 |
| 1538339395 | Joseph Michael Mozena | Podiatrist | 2227 Ne Hancock St, Portland, OR 97212-4873 | 2008-03-08 |
| 1245443100 | Daniel L Nusser | Podiatrist | 2809 Ne Broadway, Portland, OR 97232 | 2007-05-08 |
| 1114048667 | Dr John D Mozena Dpm PC | Podiatrist | 8305 Se Monterey Ave Ste 101, Portland, OR 97266-7728 | 2007-04-03 |
| 1124116231 | Ray A Mcclanahan | Podiatrist | 725 Nw 19th Ave, Portland, OR 97209 | 2006-10-11 |
| 1942392113 | John M Barnes | Podiatrist | 506 Ne 49th Ave, Portland, OR 97213-2928 | 2006-09-28 |
| 1427150028 | Christopher S. Seuferling Dpm PC | Podiatrist | 7940 Se Division St, Suite E, Portland, OR 97206-1046 | 2006-09-03 |
| 1598867186 | Almira Ko | Podiatrist | 3586 Nw 112th Pl, Portland, OR 97229-4585 | 2006-09-02 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on SHANNON MARIE MEREDITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.