Shannon Small, MD
Shannon Small, MD is a Surgical Critical Care Physician in New London, CT, registered under NPI 1932360161.
Getting there
The practice address on file is 365 MONTAUK AVE, New London, CT 06320. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 79645 | CT | Surgical Critical Care Physician primary |
| 036143686 | IL | Surgical Critical Care Physician |
| 0101249001 | VA | Surgical Critical Care Physician |
Licences are recorded in 3 states: CT, IL, VA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - General Surgery
- PAC ID
- 1355581018
Enrolled in Medicare 3 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Virginia | I20190524002298 | Practitioner - General Surgery |
| New York | I20210723002918 | Practitioner - General Surgery |
| Connecticut | I20250121000372 | Practitioner - General Surgery |
Medicare enrolment is recorded as approved under the provider type Practitioner - General Surgery. There are 3 separate enrolment records across 3 states (VA, NY, CT). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 3 states
This provider holds licences in 3 states: Connecticut, Illinois and Virginia. The practice address on file is in New London, CT, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 79645
- Specialty
- Surgical Critical Care Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Surgical Critical Care covers
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. NUCC Health Care Provider Taxonomy, code 2086S0102X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2086S0102X | Surgical Critical Care Physician Surgical Critical Care | 79645 | CT | primary |
| 2086S0102X | Surgical Critical Care Physician Surgical Critical Care | 036143686 | IL | |
| 2086S0102X | Surgical Critical Care Physician Surgical Critical Care | 0101249001 | VA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1932360161 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 20, 2008 |
| Last updated | Nov 11, 2024 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
365 MONTAUK AVE New London, CT 06320 (860) 443-3147 Fax (860) 865-2395 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 9 | 3 | 2 | 3 | 6 | 0 | 1 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 9 | 6 | 2 | 6 | 6 | 0 | 1 | 3 |
Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.