SAMANTHA LEE KOCIEMBA (NPI# 1780151555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780151555 |
| Entity Type | Individual |
| Full Name | SAMANTHA LEE KOCIEMBA |
| Practice Address |
1755 17th Ave E Shakopee MN 55379-3372 |
| Practice Telephone | 9524455250 |
| Mailing Telephone | 9524455250 |
| Mailing Fax Number | 9524455350 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MASSAGE | 1356513592 | 01 |
| Street Address |
1755 17TH AVE E |
| City | SHAKOPEE |
| State | MN |
| Zip Code | 55379-3372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477613487 | Jodi Ann Church | Chiropractor | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2006-12-11 |
| 1629692173 | Marina Matthys | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2020-06-01 |
| 1033730890 | Jennifer Ashly Dorn | Chiropractor | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2020-05-04 |
| 1265950778 | Natalia Bureac | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2017-09-05 |
| 1952839011 | Vanessa Pagan | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2017-06-01 |
| 1376082495 | Holly Peterson | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2017-02-22 |
| 1275084378 | Grigoriy Kuznetsov | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2016-10-24 |
| 1356708184 | Stephanie Foust | Chiropractor | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2016-01-25 |
| 1881050011 | Irina Ryazanov | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2016-01-04 |
| 1730560384 | Irina Yablochkina | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2015-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1154988236 | Benedictine Living Community of Shakopee LLC | Assisted Living Facility | 1705 Windermere Way, Shakopee, MN 55379 | 2019-05-23 |
| 1346741394 | Expressions In Motion LLC | Speech-Language Pathologist | 1221 East 4th Ave., Shakopee, MN 55379 | 2018-02-26 |
| 1124529334 | A.m Dental Professionals P.a | Clinic/Center | 1036 1st Ave E, Shakopee, MN 55379 | 2018-02-22 |
| 1538522024 | Jesse Sylvester | Chiropractor | 1275 Ramsey Street South, #600, Shakopee, MN 55379 | 2016-04-01 |
| 1376903963 | Dakota Best Transportation LLC | Non-emergency Medical Transport (VAN) | 449 Dakota Street Apt 2, Shakopee, MN 55379 | 2016-02-25 |
| 1568856631 | Tatyana Mishkin Gleyzer | Nurse Practitioner | 1010 West Sixth Avenue, Shakopee, MN 55379 | 2015-03-26 |
| 1245634039 | Kalli Ledel | Pharmacist | 1198 Vierling Dr, Cub Pharmacy, Shakopee, MN 55379 | 2014-10-22 |
| 1487992913 | Jennifer Elizabeth Boyd | Nurse Practitioner | Pediatrics 1415 St Francis Ave, Park Nicollet Clinic-shakopee, Shakopee, MN 55379 | 2013-01-17 |
| 1013253798 | Acts Therapy LLC | Counselor | 8170 Old Carriage Court North, 215, Shakopee, MN 55379 | 2012-12-27 |
| Find all providers in zip 55379 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164996724 | Angelique Gabrielle Vogel | Massage Therapist | 1061 Madison St S, Shakopee, MN 55379-2056 | 2019-01-17 |
| 1548518947 | Daniel Deforest Williams | Massage Therapist | 824 Ferdinand Dr, Shakopee, MN 55379-3940 | 2012-08-16 |
| 1548516537 | Molly Dose | Massage Therapist | 113 Lewis St S, Shakopee, MN 55379-1446 | 2012-07-27 |
| 1942446646 | Julie Olson | Massage Therapist | 1667 17th Ave E Ste 103b, Shakopee, MN 55379-4433 | 2008-12-30 |
| 1629692173 | Marina Matthys | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2020-06-01 |
| 1265950778 | Natalia Bureac | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2017-09-05 |
| 1952839011 | Vanessa Pagan | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2017-06-01 |
| 1376082495 | Holly Peterson | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2017-02-22 |
| 1881137560 | Amber Gene Angell | Massage Therapist | 287 Marschall Rd, Suite 101, Shakopee, MN 55379 | 2016-11-29 |
| 1275084378 | Grigoriy Kuznetsov | Massage Therapist | 1755 17th Ave E, Shakopee, MN 55379-3372 | 2016-10-24 |
| Find all providers in SHAKOPEE | ||||
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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.