SHANNON MARIE MEREDITH DPM NPI 1407897614

NPI Information

NPI: 1407897614
Provider Name: SHANNON MARIE MEREDITH, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
195 FORE RIVER PKWY
SUITE 210
PORTLAND, ME
ZIP 04102
Phone: (207) 553-6682
Get Directions

Shannon Marie Meredith, DPM is a podiatrist in Portland, ME with 32 years of experience. The provider is 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. Shannon Marie Meredith, DPM NPI is 1407897614. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

195 FORE RIVER PKWY
SUITE 210
PORTLAND, ME
ZIP 04102-780
Phone: (207) 553-6682
Fax: (207) 553-6681

The NPI 1407897614 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/9/2006 and was last updated on 8/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		1000	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100429800	OTHER		DEPT OF LABOR
2	127440000	MEDICAID	MAINE
3	480016606	OTHER	MAINE	RAILROAD MEDICARE
4	1069320001	MEDICARE NSC	MAINE
5	MM5552	MEDICARE PIN	MAINE
6	001299	OTHER	MAINE	MARTINS POINT
7	14284	OTHER		FEDERAL BLUE SHIELD
8	014284	OTHER	MAINE	ANTHEM BLUE CROSS
9	U47765	OTHER	MAINE	HARVARD PILGRIM
10	U47765	MEDICARE UPIN
11	104104	OTHER	MAINE	AETNA
12	MM555201	MEDICARE PIN	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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