SHANNON MARIE SMITH (NPI# 1346463924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346463924 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE SMITH |
| Practice Address |
5200 Fairview Blvd Wyoming MN 55092-8013 |
| Mailing Address |
8028 242nd Ave Ne Stacy MN 55079-9310 |
| Practice Telephone | 6519827000 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | 7892 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568203 | Shannon Smith | Counselor | 99 Huckleberry Ct, Three Bridges, NJ 08887-2109 | 2020-11-08 |
| 1821603267 | Shannon Alexandria Smith | Dietitian, Registered | 20621 Ne 1st Ct, Miami, FL 33179-1702 | 2020-09-12 |
| 1790316040 | Shannon Machelle Smith | Nurse Practitioner | 7705 Happy Hollow Dr, Mint Hill, NC 28227-8518 | 2020-01-27 |
| 1750925392 | Shannon Joy Smith | Nurse Practitioner | 152 Pearson Rd, Greer, SC 29651-7146 | 2019-11-06 |
| 1104308014 | Shannon Lynn Smith | Massage Therapist | 15131 Northville Rd, Plymouth, MI 48170-2548 | 2018-09-06 |
| 1548747181 | Shannon Marie Smith | Psychologist | 146 2nd St N Ste 305, Saint Petersburg, FL 33701-3361 | 2018-07-26 |
| 1942726393 | Shannon Elizabeth Smith | Counselor | 3535 S Sherwood Forest Blvd Ste 227, Baton Rouge, LA 70816-2255 | 2017-08-17 |
| 1043749450 | Shannon Michelle Smith | Marriage & Family Therapist | 707 W 5th Ave Apt 1116, Spokane, WA 99204-2780 | 2017-06-08 |
| 1033640644 | Shannon Elizabeth Smith | Social Worker | 212 W Red Bridge Rd, Kansas City, MO 64114-5136 | 2017-03-24 |
| 1518311240 | Shannon Kathleen Smith | Licensed Practical Nurse | 9040 Jackson Avenue, Attn Mchk-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2016-04-19 |
| Street Address |
5200 FAIRVIEW BLVD |
| City | WYOMING |
| State | MN |
| Zip Code | 55092-8013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061371 | Gunnar Jon Erickson | Ophthalmology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2005-05-24 |
| 1902414378 | Fairview Express Care | General Practice | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-07-21 |
| 1023648235 | Cassandra L Etheridge | Physician Assistant | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-01-16 |
| 1023652211 | Natasha Lackas | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-10-31 |
| 1467019414 | Terrence Ellis | Clinical Exercise Physiologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-24 |
| 1790341493 | Krystal Kraemer | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-17 |
| 1225509037 | Lauren Downie | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-12-06 |
| 1861977787 | Magdalen Rene Gadbois | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-09-26 |
| 1285110338 | Marie Hudalla | Physical Therapist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-07-12 |
| 1023502697 | Molly Levy | Nurse Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1851909436 | Matthew Rohlf | Dentist | 5378 E Viking Blvd, Wyoming, MN 55092 | 2020-07-20 |
| 1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
| 1609425966 | Faith Bouttell | Technician | 25423 Heims Lake Circle, Wyoming, MN 55092 | 2019-09-10 |
| 1275875031 | Fairview Express Care | Clinic/Center | 5130 Fairview Blvd, Suite 101, Wyoming, MN 55092 | 2013-03-20 |
| 1023385242 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 5200 Fairview Blvd., Wyoming, MN 55092 | 2011-11-17 |
| 1902851876 | Tamara Piroska Petrac-halatsis | Obstetrics & Gynecology | 5200 Fairview Boulevard, Ob/gyn Department, Wyoming, MN 55092 | 2006-05-22 |
| 1376922070 | Carli Lynn Ceder | Physical Therapist | 5130 Fairview Blvd, Wyoming, MN 55092 | 2015-05-27 |
| 1396087433 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 5130 Fairview Blvd, Suite 104, Wyoming, MN 55092 | 2013-03-26 |
| 1598007726 | Fairview Health Services | Prosthetic/Orthotic Supplier | 5130 Fairview Blvd, Suite 103, Wyoming, MN 55092 | 2013-03-26 |
| Find all providers in zip 55092 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1376993683 | Arianna Aguilar | Rehabilitation Practitioner | 2742 Woodlake Rd Sw, Apt 6, Wyoming, MI 49519-4634 | 2016-06-16 |
| 1003160979 | Randy Lee Denooyer | Rehabilitation Practitioner | 3280 Michael Ave Sw, Wyoming, MI 49509-2738 | 2012-10-31 |
| 1689127144 | Bryce Kramer | Rehabilitation Practitioner | 3280 Michael Ave Sw, Wyoming, MI 49509-2738 | 2016-08-01 |
| 1629190954 | Bernadette Ann Hoisington | Rehabilitation Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2007-04-06 |
| 1003987363 | Linda Koehler | Rehabilitation Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615612 | Livelife Therapy Solutions | Rehabilitation Practitioner | 8100 Penn Ave S Ste 137, Bloomington, MN 55431-1325 | 2019-12-09 |
| 1962067611 | Connor Hanson | Rehabilitation Practitioner | 718 1st Ave Nw, New Brighton, MN 55112-6809 | 2019-05-08 |
| 1780963355 | Center for Primary Care and Rehabilitation, Pa | Rehabilitation Practitioner | 880 Blue Gentian Rd Ste 165, Eagan, MN 55121-1772 | 2011-08-12 |
| 1518192756 | David Michael Noren | Rehabilitation Practitioner | 521 Broadway Ave N, Braham, MN 55006 | 2009-05-18 |
| 1972764454 | Laura Lynn Kirlin | Rehabilitation Practitioner | 515 Bridge St. East, Park Rapids, MN 56470-1810 | 2008-06-18 |
| 1801084140 | Anthony Kroll | Rehabilitation Practitioner | 3609 White Bear Ave N, Suite #202, White Bear Lake, MN 55110-4466 | 2007-10-11 |
| 1609906734 | Paul Daniel Nistler | Rehabilitation Practitioner | 722 15th Street Ne, Bemidji, MN 56601 | 2007-03-07 |
| 1881747483 | Richard Marquardt | Rehabilitation Practitioner | Upper Mississippi Mental Health Center, 120 N Main Street, Park Rapids, MN 56470 | 2007-01-19 |
| 1346327004 | Shawn D. Anderson | Rehabilitation Practitioner | 515 Bridge St, Park Rapids, MN 56470-1210 | 2006-11-01 |
| 1639131279 | Samuel Fedo | Rehabilitation Practitioner | 501 E Nicollet Blvd, Suite 100, Burnsville, MN 55337-6732 | 2006-04-06 |
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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.