SHANNON MARIE MEREDITH (DPM) – Podiatrist, NPI 1407897614

SHANNON MARIE MEREDITH (DPM) is a healthcare provider. based in Portland, Maine. specializing in PODIATRY. They hold the professional credentials DPM. They hold a License No. 1000 (ME). The NPI Number for SHANNON MARIE MEREDITH (DPM) is 1407897614

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON MARIE MEREDITH (DPM)
NPI
1407897614
Phone
(207) 879-3000
Address
144 STATE ST
Enumeration Date
9 June 2006
Last Update Date
18 August 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2075648401
Graduation Year
1992 (34 years ago)
PAC ID
2466493887
Group Practice PAC ID
1355770892
Professional Enrollment ID
I20050517000053
Address ID
ME044261029DO897XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

69 PODIATRY in ME

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Provider Addresses for SHANNON MARIE MEREDITH (DPM)

  • Mercy Hospital, 144, State Street, Old Port, Portland, Cumberland County, Maine, 04102, United States

    PORTLAND, ME 041013776

    Phone: (207) 879-3000

    Type: Mailing

  • 195, Fore River Parkway, Libbytown, Portland, Cumberland County, Maine, 04102, United States

    SUITE 210

    PORTLAND, ME 041022780

    Phone: (207) 553-6682

    Fax: (207) 553-6681

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050517000053IPodiatryMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04101)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355770892View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)ME
General SurgeryVA
Physician AssistantME
Nurse PractitionerME
-ME
Physician AssistantME
Certified Registered Nurse Anesthetist (Crna)ME
Family PracticeME
Family PracticeME
Nurse PractitionerME

Reviews

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Frequently asked questions

Can I verify SHANNON MARIE MEREDITH (DPM) with an NPI only?
You can start verification with NPI 1407897614 for SHANNON MARIE MEREDITH (DPM), then check state licensing separately.
Can I rely on SHANNON MARIE MEREDITH (DPM) being an active provider?
As of the registry snapshot, SHANNON MARIE MEREDITH (DPM) is marked active.
What is SHANNON MARIE MEREDITH (DPM)'s specialty?
The listing groups SHANNON MARIE MEREDITH (DPM) with Podiatrist. Clinical services aligned with this taxonomy classification.
Does SHANNON MARIE MEREDITH (DPM) list a practice location?
Patients near Portland, Maine may find SHANNON MARIE MEREDITH (DPM) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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