MS. SHANNON L AVERY-DESMARAIS (NPI# 1053713453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053713453 |
| Entity Type | Individual |
| Full Name | MS. SHANNON L AVERY-DESMARAIS |
| Credential | MSN, NP-C |
| Practice Address |
827 American Legion Hwy Westport MA 02790-4128 |
| Mailing Address |
200 Mill Rd Ste 180 Fairhaven MA 02719-5255 |
| Practice Telephone | 5086365101 |
| Practice Fax Number | 5086363651 |
| Mailing Telephone | 5089732000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2020-04-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN152968 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110101239A | 05 |
| Street Address |
827 AMERICAN LEGION HWY |
| City | WESTPORT |
| State | MA |
| Zip Code | 02790-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073502431 | Jane M Li | Family Medicine | 827 American Legion Hwy, Westport, MA 02790-4128 | 2005-10-18 |
| 1083196844 | Jacqueline Freitas Rosa | Nurse Practitioner | 827 American Legion Hwy, Westport, MA 02790-4128 | 2018-08-29 |
| 1336552223 | Binu S Oien | Family Medicine | 827 American Legion Hwy, Westport, MA 02790-4128 | 2014-06-09 |
| 1730508557 | Southcoast Physicians Group, Inc. | Family Medicine | 827 American Legion Hwy, Westport, MA 02790-4128 | 2014-04-09 |
| 1366456360 | Nancy D. Carney | Family Medicine | 827 American Legion Hwy, Westport, MA 02790-4128 | 2006-07-28 |
| 1225093362 | Marivyl J. Laxer | Internal Medicine | 827 American Legion Hwy, Westport, MA 02790-4128 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154637536 | Veronica Joy Gagnon | Dental Hygienist | 15 Miss Rachel Trl, Po Box N171, Westport, MA 02790 | 2010-08-24 |
| 1447417837 | Karen M Burns | Registered Nurse | 780 Main Road, The Comfort of Touch, Westport, MA 02790 | 2008-05-22 |
| 1275743833 | Eric Vohnoutka | Chiropractor | 93 Union St., Westport, MA 02790 | 2007-05-23 |
| 1952322620 | Andrea Ghenta-drimbarean | Dentist | 767 Main Rd, Westport, MA 02790 | 2006-07-21 |
| 1063438349 | Westport Chiropractic, Inc | Chiropractor | 637 State Rd., Westport, MA 02790 | 2006-07-13 |
| 1053378646 | Mark P. Richard | Nurse Practitioner | 827 American Legion Highway, Westport, MA 02790 | 2006-04-27 |
| 1902153893 | Care Resource, LLC | Home Health | 829 Main Rd, Westport, MA 02790 | 2012-08-09 |
| 1578827689 | Mary Jane Mello | Dentist | 302 Village Way, Westport, MA 02790 | 2012-07-03 |
| 1083628382 | Karen Ottenstein | Family Medicine | 793 Main Rd, Westport, MA 02790 | 2006-07-29 |
| 1841564085 | Girard & Associates LLC | Local Education Agency (LEA) | 13 Kyle Jacob Rd, Westport, MA 02790-0696 | 2012-03-06 |
| Find all providers in zip 02790 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666203 | Eileen Whyte O'holleran | Nurse Practitioner | 12 Autumn Ln, South Hamilton, MA 01982-1400 | 2020-10-14 |
| 1356948525 | Kaylee Woods | Nurse Practitioner | 85 Seaport Blvd Unit 714, Boston, MA 02210-2157 | 2020-10-01 |
| 1063026946 | Alexandra Louise Lester | Nurse Practitioner | 7 Doris Cir, Newton, MA 02458-1929 | 2020-09-08 |
| 1023627833 | Jennifer Suxin Yu | Nurse Practitioner | 63 Cedar St, Malden, MA 02148-3647 | 2020-07-28 |
| 1417566563 | Julianna Marie Roberts | Nurse Practitioner | 5 Helen Dr, Peabody, MA 01960-1235 | 2020-07-24 |
| 1144838384 | Amanda Rose Bakos | Nurse Practitioner | 218 Marion St, Boston, MA 02128-1758 | 2020-07-14 |
| 1710504949 | Angela Vu | Nurse Practitioner | 83 Nightingale Ave # 1l, Quincy, MA 02169-6413 | 2020-07-03 |
| 1083236749 | Mubina M Rhee | Nurse Practitioner | 170 Brookline Ave Unit 215, Boston, MA 02215-3921 | 2020-05-15 |
| 1841823911 | Rachel N Mick | Nurse Practitioner | 77 Winsor St Ste 103, Ludlow, MA 01056-3470 | 2020-02-18 |
| 1326670803 | Ashley Laverdiere | Nurse Practitioner | 1 Ferncroft Rd, Danvers, MA 01923-4017 | 2020-02-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MS. SHANNON L AVERY-DESMARAIS.
| 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.