SHELBY MARTIN (NPI# 1629514401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629514401 |
| Entity Type | Individual |
| Full Name | SHELBY MARTIN |
| Credential | ATC |
| Practice Address |
5750 Christmas Lake Rd Excelsior MN 55331-3303 |
| Practice Telephone | 9524121411 |
| Mailing Telephone | 9524121411 |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-04-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | ANTHEM BLUE CROSS | FXF656A22785 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588201941 | Shelby Martin | Specialist/Technologist | 252 N Yates St # 161, Pewamo, MI 48873-5132 | 2019-12-04 |
| 1053878348 | Shelby Pamela Martin | Radiology | 601 Highway 6 W, Iowa City, IA 52246-2209 | 2019-02-22 |
| 1386136968 | Shelby Jayne Martin | Student in an Organized Health Care Education/Training Program | 1 Ohio University Dept of Psychology, Porter Hall Room 002, Athens, OH 45701 | 2018-05-31 |
| 1063903466 | Shelby Lynn Martin | Social Worker | 1349 E Stroop Rd, Kettering, OH 45429-4925 | 2018-05-22 |
| 1760973192 | Shelby Rae Martin | Speech-Language Pathologist | 120 Oslo Cir, Birmingham, AL 35211-5965 | 2018-05-21 |
| 1881127637 | Shelby Martin | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Ter, Gainesville, FL 32605-4218 | 2017-04-08 |
| 1215390547 | Shelby N Martin | Specialist/Technologist | 1700 Dogwood Mile St, Laurinburg, NC 28352-5521 | 2016-04-04 |
| Street Address |
5750 CHRISTMAS LAKE RD |
| City | EXCELSIOR |
| State | MN |
| Zip Code | 55331-3303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609432798 | Christina Mccullough Dds Pllc | Dentist | 2455 Shadywood Road, Orono, MN 55331 | 2019-05-14 |
| 1558854042 | Melissa Ann Morency | Massage Therapist | 23505 County Road 19, Excelsior, MN 55331 | 2018-06-11 |
| 1801388475 | Susanne B Kanter | Physical Therapist | 23490 Mn-7, Shorewood, MN 55331 | 2018-05-30 |
| 1518367440 | Danielle Marie O'connell | Chiropractor | Knewtson Health Group, 23505 Smithtown Rd Suite 100, Excelsior, MN 55331 | 2014-08-28 |
| 1467893511 | Allison Scott | Pharmacist | 23800 Mn Hwy 7, Shorewood, MN 55331 | 2013-07-17 |
| 1417204751 | Minnetonka Psychology and Wellness | Marriage & Family Therapist | 19765 Highway 7, Suite 203, Shorewood, MN 55331 | 2012-08-06 |
| 1952623456 | Virginia Lee Sievers Green | Occupational Therapist | 464 2nd Street, Suite 105, Excelsior, MN 55331 | 2010-02-24 |
| 1497980163 | Harmonia Health Care | Home Health | 3121 Pillsbury Ave S, Minneapolis, MN 55331 | 2009-05-24 |
| 1831352731 | Kelli J O'shea | Occupational Therapist | 19685 Hwy 7, Shorewood, MN 55331 | 2008-07-10 |
| 1922295658 | Nueva Era Healthcare Services, Inc. | Home Health | 5667 Wood Duck Circle, Shorewood, MN 55331 | 2007-09-26 |
| Find all providers in zip 55331 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891202511 | Christine Ann Gagnon | Specialist/Technologist | 5885 Mill St, Excelsior, MN 55331-3210 | 2018-01-03 |
| 1447604079 | Alexandra Ashbaugh | Specialist/Technologist | 7329 Hazeltine Blvd, Excelsior, MN 55331-8038 | 2016-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092165 | Jamie Lynn Erickson | Specialist/Technologist | 43628 374th Ln, Aitkin, MN 56431-4027 | 2020-10-27 |
| 1760082044 | Craig Daniel Merten | Specialist/Technologist | 5045 Division Ave # 5575, White Bear Lake, MN 55110-2663 | 2020-10-27 |
| 1154928927 | Heidi Frey | Specialist/Technologist | 4554 Lake Park Ct, Eagan, MN 55122-2515 | 2020-10-05 |
| 1851906887 | Teddy Ray Gildersleeve | Specialist/Technologist | 37320 Oriole Ave, Lindstrom, MN 55045-9109 | 2020-09-15 |
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1952916793 | Megan Marie Hautajarvi | Specialist/Technologist | 2536 Peace Dr, Duluth, MN 55811-2971 | 2020-09-09 |
| 1871108795 | Bryce Mershon Beamish | Specialist/Technologist | 3501 Lowell St, Wayzata, MN 55391-3411 | 2020-09-09 |
| 1043825961 | Kevin Eskuri | Specialist/Technologist | 8090 172nd St W, Lakeville, MN 55044-6206 | 2020-09-09 |
| 1952916876 | Elizabeth Marie Altendorf | Specialist/Technologist | 1621 397th Ave Ne, Stanchfield, MN 55080-3303 | 2020-09-09 |
| 1699380519 | Kourtney Jean Palmi | Specialist/Technologist | 4922 Howard Gnesen Rd, Duluth, MN 55803-2710 | 2020-09-09 |
| 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.