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Deactivated NPI 1609857879 Deactivated / Inactive NPI Male Practitioner

Dr. Daniel Charles Shannon , MD

Pediatrics • Boston, MA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Daniel Shannon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 07, 2005
NPI Deactivation Date November 02, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Daniel Shannon, MD was a registered Pediatrics practicing in Boston, MA. Throughout an active medical career spanning 17 years, Dr. Shannon provided care at the practice location at 55 FRUIT ST until profile deactivation on 2022-11-02.

Practice Location & Contact Primary Location

Practice Address

55 Fruit St
Yaw 6b Pediatric Pulmonary

Boston, MA 02114

Telephone 6177268707
Fax 6177261036
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Boston, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.8 Yrs
State Avg: 25.7 Yrs
Regional Practice Density
848 Specialists

Practicing in Boston, MA (2760 Statewide)

Telehealth Adoption Rate
0.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MA 27945

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

24 Associated Practitioners
Alexander Ing , MS CGC

Genetic Counselor, MS

NPI 1073066262

MSCGC

NPI 1083429757

Doctor of Pharmacy (Pharm.D.)

NPI 1215503594

Doctor of Medicine (M.D.)

Jill Bolduc , CPNP-PC

Nurse Practitioner

NPI 1215666839

CPNPPC

Dr. Mengdi Lu , MD

Pediatrics - Pediatric Pulmonology

NPI 1225470222

Doctor of Medicine (M.D.)

Jennifer Stockbridge , NP

Nurse Practitioner - Family

NPI 1306866793

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 02, 2022

Record deactivated on November 02, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 55 FRUIT ST, YAW 6B PEDIATRIC PULMONARY, BOSTON, MA 02114 (Tel: 6177268707)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 021299142 (Tel: 6177240287)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DANIEL SHANNON, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #27945 in MA)

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Initial NPI Registration & Enumeration November 07, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1609857879
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2005
Last Update: July 08, 2007
Deactivation Date: November 02, 2022

Mailing Address

Po Box 9142, Mass General Physician Organization

Charlestown, MA 021299142

Phone: 6177240287

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.