SHANE M MEYER (NPI# 1154675577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154675577 |
| Entity Type | Individual |
| Full Name | SHANE M MEYER |
| Credential | PA-C |
| Practice Address |
1720 University Dr S Fargo ND 58103-4940 |
| Mailing Address |
Po Box 2168 Fargo ND 58107-2168 |
| Practice Telephone | 7012342251 |
| Practice Fax Number | 7012342050 |
| Mailing Telephone | 7012342119 |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PAC0508 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568844140 | Shane Meyer | Occupational Therapy Assistant | 309 Park St, Apartment 1, Fort Atkinson, WI 53538-2167 | 2015-06-19 |
| 1396158788 | Shane Meyer | Counselor | 300 S 68th Street Pl, Suite 500, Lincoln, NE 68510-2475 | 2014-06-04 |
| Street Address |
1720 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609852136 | Scci Hospitals of America Inc. | Long Term Care Hospital | 1720 University Dr S, Fargo, ND 58103-4940 | 2005-12-16 |
| 1154921914 | Ailsa Anne Falck | Speech-Language Pathologist | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-10-29 |
| 1225635634 | Sanford Medical Center Fargo | Pharmacy | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-10-08 |
| 1821607169 | Catrina Olson Armstrong | Speech-Language Pathologist | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-07-22 |
| 1730726662 | Jessica A Olson | Occupational Therapist | 1720 University Dr S, Fargo, ND 58103-4940 | 2019-12-10 |
| 1033763065 | Andrea Sailer | Speech-Language Pathologist | 1720 University Dr S, Fargo, ND 58103-4940 | 2019-07-29 |
| 1821657388 | Amanda Beth Reber | Nurse Practitioner | 1720 University Dr S, Fargo, ND 58103-4940 | 2019-06-10 |
| 1881167815 | Andrea Sluke | Occupational Therapist | 1720 University Dr S, Fargo, ND 58103-4940 | 2019-01-02 |
| 1972081982 | Michaela Johnson | Occupational Therapist | 1720 University Dr S, Fargo, ND 58103-4940 | 2018-08-01 |
| 1518444363 | Lori K Blomquist | Counselor | 1720 University Dr S, Fargo, ND 58103-4940 | 2018-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538783972 | Austin Fridrich | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-06-02 |
| 1477053411 | Sara Amys | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2018-02-16 |
| 1902262595 | Evelyne S Akoth | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2016-01-12 |
| 1508274408 | Daniel Deutsch | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2014-07-24 |
| 1609213529 | Kathryn B Fuss | Physician Assistant | 801 Broadway N, Fargo, ND 58102-3641 | 2013-06-01 |
| 1043231269 | Teresa Marie Reinholz | Physician Assistant | 2301 25th St S, Fargo, ND 58103-6104 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629423371 | Carly Schlosser | Physician Assistant | 300 N 7th St, Bismarck, ND 58501-4439 | 2016-05-02 |
| 1164859831 | Kristen Schaff | Physician Assistant | 401 N 9th St, Bismarck, ND 58501-4530 | 2013-09-26 |
| 1801104039 | Nicole Frank | Physician Assistant | 310 N 9th St, Bismarck, ND 58501-4515 | 2010-09-22 |
| 1679891907 | Patrick Roger Walter | Physician Assistant | 904 5th Ave Ne, Jamestown, ND 58401-3437 | 2010-05-11 |
| 1538250246 | Kenneth Kessler | Physician Assistant | 310 N 10th St, Bismarck, ND 58501-4516 | 2006-09-27 |
| 1457451981 | Ilene Brackin | Physician Assistant | 310 N 10th St, Bismarck, ND 58501-4516 | 2006-09-24 |
| 1023118775 | Douglas Harding | Physician Assistant | 310 N 10th St, Bismarck, ND 58501-4516 | 2006-09-23 |
| 1265538607 | Debra E Held | Physician Assistant | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-09-15 |
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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.