MR. SHANNON CARL NELSON (NPI# 1104029388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104029388 |
| Entity Type | Individual |
| Full Name | MR. SHANNON CARL NELSON |
| Credential | OTR |
| Practice Address |
Highway 1 Box 497 Red Lake MN 56671 |
| Mailing Address |
Po Box 299 Bagley MN 56621-0299 |
| Practice Telephone | 2186793316 |
| Mailing Telephone | 2186793316 |
| Mailing Fax Number | 2186793990 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 102239 | MN | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | OCCUPATIONAL THERAPY LIC. | 102239 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881206431 | Shannon Marie Nelson | Technician | 19 Double H Farm Rd, Pennsboro, WV 26415-6234 | 2020-08-17 |
| 1598008781 | Shannon Casey Nelson | Social Worker | 802 S Skyline Dr, Carbondale, IL 62901-2406 | 2013-04-05 |
| 1780996249 | Shannon B. Nelson | Pharmacist | 13426 Yaupon Holly Ln, Houston, TX 77044-4941 | 2010-07-12 |
| 1487636023 | Shannon C Nelson | Pharmacist | 6904 Beth Ave, Papillion, NE 68133-2119 | 2005-11-18 |
| 1972076875 | Shannon Nelson | Nurse Anesthetist, Certified Registered | 1901 Clinch Ave, Knoxville, TN 37916-2307 | 2019-01-03 |
| 1093245169 | Shannon Ann Nelson | Physical Therapy Assistant | 8507 Ne 8th Way, Vancouver, WA 98664-1980 | 2017-06-12 |
| 1225435050 | Shannon Nelson | Counselor | 21000 Rogers Dr, Suite 200, Rogers, MN 55374-4652 | 2014-11-21 |
| 1598180861 | Shannon K. Nelson | Marriage & Family Therapist | 6322 Sovereign St, Bldg 1 Ste 263, San Antonio, TX 78229-5142 | 2014-02-24 |
| 1407150675 | Shannon Vincent Nelson | Speech-Language Pathologist | 4500 Bissonnet St, Suite 340, Bellaire, TX 77401-3120 | 2011-01-03 |
| 1699941062 | Shannon L. Nelson | Physical Therapist | 516 E. Nizhoni Blvd., Gallup, NM 87301-1337 | 2008-05-05 |
| Street Address |
HIGHWAY 1 BOX 497 |
| City | RED LAKE |
| State | MN |
| Zip Code | 56671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030419 | Red Lake Homeless Shelter Inc. | Case Management | 15855 Main Ave, Red Lake, MN 56671 | 2020-07-13 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1538445978 | Hoaibac Nguyen | Pharmacist | 24760 Hospital Rd, Red Lake, MN 56671 | 2011-10-31 |
| 1639466048 | Red Lake Comprehensive Health Services | Dental Hygienist | 24809 Hospital Drive, Highway 1, Redlake, MN 56671 | 2011-07-06 |
| 1821391822 | Jill Christine Andersen | Physical Therapist | Hwy 1 Hospital Dr. Box 497, Red Lake, MN 56671 | 2010-12-13 |
| 1871802934 | Elizabeth Vivian Rose | Dentist | 24760 Hospital Dr., Red Lake, MN 56671 | 2010-10-06 |
| 1225202625 | Redlake Chemical Health Program Group Home | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
| 1194930040 | Emcare | Clinic/Center | Phs Indian Hospital Hwy 1 Po 497, Red Lake, MN 56671 | 2007-05-14 |
| Find all providers in zip 56671 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508809765 | Phs Indian Hospital | General Acute Care Hospital | Hwy 1 Hospital Dr, Box 497, Red Lake, MN 56671-0497 | 2006-06-14 |
| 1972644318 | Pharmacy Dept. Phs Indian Hopsital | General Acute Care Hospital | Hwy 1, Box 497, Red Lake, MN 56671 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811372360 | Karin Costin | General Acute Care Hospital | 803 E 28th St, Minneapolis, MN 55407 | 2015-07-27 |
| 1619317070 | Allegheny General Hospital | General Acute Care Hospital | 724 4th St Sw, Rochester, MN 55902-2913 | 2013-07-01 |
| 1003196361 | Fairview | General Acute Care Hospital | 21282 Inspiration Ct, Lakeville, MN 55044-6027 | 2011-08-18 |
| 1356652481 | Spectrum Health | General Acute Care Hospital | 25850 Brolin Beach Rd, Detroit Lakes, MN 56501-7978 | 2010-06-23 |
| 1093960742 | Fairview Health Services | General Acute Care Hospital | 13017 Lakeview Dr, Burnsville, MN 55337-3857 | 2008-11-22 |
| 1144477282 | Allina Home Care Hospice and Palliative Care | General Acute Care Hospital | 1055 Westgate Dr. Suite 100, St. Paul, MN 55114-1451 | 2008-08-20 |
| 1356559983 | Rtgmedical | General Acute Care Hospital | 2186 Baneberry Way W, Chanhassen, MN 55317 | 2007-05-18 |
| 1730232307 | Jack Ramon Lees | General Acute Care Hospital | 2146 Lemay Lake Dr, Mendota Heights, MN 55120-1183 | 2007-01-18 |
| 1245349257 | Russell Vincent Luepker | General Acute Care Hospital | 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 | 2006-08-30 |
| 1275642134 | Eleah Medical Center | General Acute Care Hospital | 930 1st St Ne, Elbow Lake, MN 56531-4611 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.