MEDICARE: MR. SHAYNE MCMAHON FOLEY M.S., PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	055.0031413	VT

General Provider Information

NPI Number	:	1598012213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAYNE MCMAHON FOLEY M.S., PA-C

Provider Business Mailing Address
First Line	:	PO BOX 2000
Second Line	:
City	:	RANDOLPH
State	:	VT
Zip	:	05060-2000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2418 AIRPORT RD STE 1
Second Line	:
City	:	BARRE
State	:	VT
Zip	:	05641-8702
Country	:	US
Telephone Number	:	802-224-3200
Fax Number	:	207-282-9128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2012
Last Update Date	:	11/06/2025

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