SHANNON ELIZABETH KOENDERS (NPI# 1902391626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902391626 |
| Entity Type | Individual |
| Full Name | SHANNON ELIZABETH KOENDERS |
| Credential | OD |
| Practice Address |
15704 90th St Ne # 100 Otsego MN 55330-7448 |
| Mailing Address |
11901 Central Park Way Unit 2313 Maple Grove MN 55369-2663 |
| Practice Telephone | 7632411090 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WV0400X |
Optometrist Specialization: Vision Therapy |
3577 | MN | Eye and Vision Services Providers |
| Street Address |
15704 90TH ST NE # 100 |
| City | OTSEGO |
| State | MN |
| Zip Code | 55330-7448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003338211 | Kelsey Marie Manescalco | Optometrist | 15704 90th St Ne # 100, Otsego, MN 55330-7448 | 2017-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504139 | Jacob Stevens | Pharmacist | 19216 Freeport Ave, Cub Pharmacy, Elk River, MN 55330 | 2020-07-01 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1346888609 | Katie Eberley | Counselor | 9425 Quantrelle Ave, Otsego, MN 55330 | 2019-12-18 |
| 1649839986 | Jodi Marie Pikula | Massage Therapist | 710 Dodge Ave, Suite C, Elk River, MN 55330 | 2019-06-11 |
| 1144793878 | Northern Cities Therapy, Inc. | Counselor | 19230 Evans St Nw Ste 100, Elk River, MN 55330 | 2019-01-04 |
| 1144715236 | Jennifer Kay Dahlseid | Chiropractor | 200 5th St Nw Ste J, Elk River, MN 55330 | 2018-06-29 |
| 1124542089 | Megan Majsterski Lazere | Counselor | 9245 Quantrelle Avenue, Otsego, MN 55330 | 2017-08-01 |
| 1134674237 | Rescare Minnesota | Community Based Residential Treatment Facility, Mental Illness | 633 Upland Ave Nw, Elk River, MN 55330 | 2016-08-18 |
| 1356894927 | Allison Benz | Counselor | 9245 Quantrelle Ave, Otsego, MN 55330 | 2016-07-29 |
| 1447615141 | Laura Stevenson | Speech-Language Pathologist | 15990 90th St., Otsego, MN 55330 | 2015-12-22 |
| Find all providers in zip 55330 | ||||
| Taxonomy Code | 152WV0400X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Vision Therapy |
| Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518092733 | Advancements In Vision, Pa | Optometrist | 9125 Quaday Ave Ne, Suite 104, Otsego, MN 55330-6651 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700163540 | Omni Vision & Learning Center | Optometrist | 9766 Fallon Ave Ne Ste 105, Monticello, MN 55362-4589 | 2011-11-08 |
| 1700113180 | Pinecone Vision Therapy Center | Optometrist | 2380 Troop Dr Unit 201, Sartell, MN 56377-4637 | 2009-11-05 |
| 1477725554 | Hemma Rusoff | Optometrist | 2705 Bunker Lake Blvd., Suite B102, Andover, MN 55304 | 2008-03-28 |
| 1164525044 | Susan Tesch | Optometrist | 1420 Bemidji Ave N, Bemidji, MN 56601-3814 | 2006-09-06 |
| 1144296484 | Leslie Todd Alsterlund | Optometrist | 3553 Hennepin Ave S, Minneapolis, MN 55408-3830 | 2006-02-27 |
| 1689285157 | Shelby Nicole May-parmley | Optometrist | 1800 2nd St Ne, Minneapolis, MN 55418-4306 | 2020-08-10 |
| 1619484078 | Thrive With Vision, Pllc | Optometrist | 118 E Broadway, Little Falls, MN 56345-3039 | 2018-01-08 |
| 1720347875 | A Chance To Grow, Inc. | Optometrist | 1800 2nd St Ne, Minneapolis, MN 55418-4306 | 2012-05-10 |
| 1770770737 | Visual Strategies of Woodbury LLC | Optometrist | 1937 Woodlane Dr, Suite 209, Woodbury, MN 55125-3926 | 2007-10-03 |
| 1912194234 | Visual Strategies of Apple Valley LLC | Optometrist | 7373 147th St W, Suite 144, Apple Valley, MN 55124-7690 | 2007-10-01 |
| 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.