SHIRLEY M ANDERSON (NPI# 1124007463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124007463 |
| Entity Type | Individual |
| Full Name | SHIRLEY M ANDERSON |
| Credential | MA CCCA |
| Practice Address |
1421 Premier Dr Mankato Clinic At Wickersham Campus Mankato MN 56001 |
| Mailing Address |
Po Box 8674 1230 E Main St Mankato MN 56002-8674 |
| Practice Telephone | 5076251811 |
| Mailing Telephone | 5076251811 |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2020-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 6054 | MN | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | AMERICAS PPO | 1758785 | 01 |
| RR MEDICARE | 640003648 | 01 | |
| MN | HEALTH PARTNERS | HP40597 | 01 |
| MN | PREFERRED ONE | NA2951023870 | 01 |
| MN | BCBS | 29Q96AN | 01 |
| MN | 586515800 | 05 | |
| MN | MEDICA | 4511090 | 01 |
| MN | UCARE | 117664 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740891878 | Shirley Ann Anderson | Technician | 1714 Doulton Ave, Huntington, WV 25701-3732 | 2020-08-12 |
| 1053687426 | Shirley W Anderson | Dietitian, Registered | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2012-03-29 |
| 1205121407 | Shirley A Anderson | Registered Nurse | 2005 Asbury Rd, Dubuque, IA 52001-3042 | 2011-06-15 |
| 1639480387 | Shirley Ann Anderson | Counselor | 1218 Griegos Rd Nw, Albuquerque, NM 87107-3752 | 2010-06-28 |
| 1144326539 | Shirley L Anderson | Occupational Therapist | 171 Ashley Ave, Charleston, SC 29425-8908 | 2006-09-15 |
| Street Address |
1421 PREMIER DR MANKATO CLINIC AT WICKERSHAM CAMPUS |
| City | MANKATO |
| State | MN |
| Zip Code | 56001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225032980 | Darla J Wrage | Pediatrics | 1421 Premier Dr, Mankato, MN 56001-6076 | 2005-06-10 |
| 1780214890 | Sarah Lynnette Martens | Physician Assistant | 1421 Premier Dr, Mankato, MN 56001-6076 | 2020-01-17 |
| 1801381603 | Nicole Fischbach | Family Medicine | 1421 Premier Dr, Mankato, MN 56001-6076 | 2018-06-25 |
| 1942732763 | Kelly Marie Bryan | Pediatrics | 1421 Premier Dr, Mankato, MN 56001-6076 | 2017-03-30 |
| 1659750701 | Amy Deehr | Pediatrics | 1421 Premier Dr, Mankato, MN 56001-6076 | 2015-05-22 |
| 1982016176 | Benjamin Cody Dexter | Pediatrics | 1421 Premier Dr, Mankato, MN 56001-6076 | 2014-05-22 |
| 1295145902 | Gillette Children's Specialty Healthcare | Prosthetic/Orthotic Supplier | 1421 Premier Dr, Suite 100, Mankato, MN 56001-6076 | 2014-05-02 |
| 1376978874 | Amanda E Bohn | Audiologist | 1421 Premier Dr, Mankato, MN 56001-6076 | 2013-09-04 |
| 1245597046 | Colin W. Weerts | Family Medicine | 1421 Premier Dr, Mankato, MN 56001-6076 | 2012-04-18 |
| 1811254022 | Meagan Crary | Nurse Practitioner | 1421 Premier Dr, Suite 100, Mankato, MN 56001-6076 | 2012-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003038654 | Frank John Pacovsky | Audiologist | 1400 Madison Ave Ste 614, Mankato, MN 56001-5488 | 2007-05-03 |
| 1477921500 | Colleen Ireland | Audiologist | 1025 Marsh St, Attn: Audiology, Mankato, MN 56001-4752 | 2015-09-06 |
| 1376978874 | Amanda E Bohn | Audiologist | 1421 Premier Dr, Mankato, MN 56001-6076 | 2013-09-04 |
| 1417276155 | Katie Elizabeth Kendhammer | Audiologist | 1015 Marsh St, Mankato, MN 56001-4752 | 2010-05-20 |
| 1992986186 | Terrie Ziegler | Audiologist | 310 Belle Ave, Mankato, MN 56001-5287 | 2007-11-16 |
| 1609074293 | Lynn M Schreiner | Audiologist | 1421 Premier Dr, Mankato Clinic At Wickersham Campus, Mankato, MN 56001 | 2007-07-05 |
| 1235330788 | Ann Wittnebel Vaubel | Audiologist | 1025 Marsh St, Mankato, MN 56001-4752 | 2007-05-31 |
| 1427161330 | Nicole Rae Krueger | Audiologist | 1025 Marsh St, Mankato, MN 56001-4752 | 2006-08-16 |
| 1538148556 | Tracy L Altmann | Audiologist | 1421 Premier Dr, Mankato Clinic At Wickersham Campus, Mankato, MN 56001 | 2006-01-10 |
| 1104809821 | Jennifer L Tunnell | Audiologist | 1025 Marsh St, Mankato, MN 56001-4752 | 2005-11-28 |
| Find all providers in MANKATO | ||||
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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.