SHAWN ANTHONY ROBERTS (NPI# 1164407524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164407524 |
| Entity Type | Individual |
| Full Name | SHAWN ANTHONY ROBERTS |
| Credential | MD |
| Practice Address |
318 East Main Street Central Lakes Medical Clinic Pa Crosby MN 56441-1691 |
| Mailing Address |
320 East Main Street Crosby MN 56441-1691 |
| Practice Telephone | 2185468375 |
| Practice Fax Number | 2185464400 |
| Mailing Telephone | 2185468375 |
| Mailing Fax Number | 2185464400 |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2012-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 43029 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 766188600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114496692 | Shawn D Roberts | Behavior Technician | 8 Wildwood Ln, Palm Coast, FL 32137-3221 | 2018-11-14 |
| 1629632187 | Shawn Douglas Roberts | Psychologist | 910 Sw E Ave, Lawton, OK 73501-4593 | 2019-04-30 |
| 1295878429 | Shawn Adele Roberts | Nurse Practitioner | 950 E Bogard Rd, Suite 103, Wasilla, AK 99654-7184 | 2007-02-15 |
| Street Address |
318 EAST MAIN STREET CENTRAL LAKES MEDICAL CLINIC PA |
| City | CROSBY |
| State | MN |
| Zip Code | 56441-1691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780770230 | Peggy A Rutman | Family Medicine | 318 East Main Street, Centeral Lakes Medical Clinic, P.a., Crosby, MN 56441-1645 | 2006-10-04 |
| 1093807786 | Diane Marie Palkert | Orthopaedic Surgery | 318 East Main Street, Central Lakes Medical Clinic Pa, Crosby, MN 56441-1691 | 2006-09-29 |
| 1881621761 | Central Lakes Medical Clinic Pa | Family Medicine | 318 East Main Street, Crosby, MN 56441-1691 | 2006-06-27 |
| 1912941493 | Donna Claypool | Nurse Practitioner | 318 East Main Street, Crosby, MN 56441-1645 | 2006-06-15 |
| 1427032275 | Charles Arlington Russell | Orthopaedic Surgery | 318 East Main Street, Central Lakes Medical Clinic Pa, Crosby, MN 56441-1691 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043381676 | Shannon Marie Smith | Chiropractor | 5 West Main Street, Crosby, MN 56441 | 2006-11-13 |
| 1841207594 | Bruce B Cunningham | Family Medicine | 320 East Main St, Crosby, MN 56441 | 2006-08-02 |
| 1215911391 | Paul R Carey | Family Medicine | 320 East Main Street, Crosby, MN 56441 | 2005-12-02 |
| 1629550975 | Samuel T Feyder | Physician Assistant | 320 East Main Street, Crosby, MN 56441 | 2018-09-04 |
| 1205299385 | Ann E Johnson | Obstetrics & Gynecology | 320 East Main Street, Crosby, MN 56441 | 2016-04-05 |
| 1407238389 | Brian Holmgren | Internal Medicine | 320 East Main Street, Crosby, MN 56441 | 2015-06-26 |
| 1285013367 | Paige Elizabeth Holmgren | Family Medicine | 320 East Main Street, Crosby, MN 56441 | 2015-05-22 |
| 1891182341 | Robert G Johnson | Surgery | 320 East Main Street, Crosby, MN 56441 | 2015-04-22 |
| 1932514320 | Melissa Sueann Dyrdal | Nurse Practitioner | 320 East Main Street, Crosby, MN 56441 | 2014-06-25 |
| 1477973063 | James J Stokman | Orthopaedic Surgery | 320 East Main Street, Crosby, MN 56441 | 2014-04-22 |
| Find all providers in zip 56441 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891182341 | Robert G Johnson | Surgery | 320 East Main Street, Crosby, MN 56441 | 2015-04-22 |
| 1356604961 | Andrew P Loveitt | Surgery | 320 East Main Street, Crosby, MN 56441 | 2012-06-19 |
| 1841275294 | Paul Andrew Severson | Surgery | 320 E Main St, Cuyuna Regional Medical Center, Crosby, MN 56441-1645 | 2005-12-08 |
| 1306820154 | Howard Marshall Mccollister | Surgery | 320 E Main St, Cuyuna Regional Medical Center, Crosby, MN 56441-1645 | 2005-12-05 |
| 1255315008 | Timothy Paul Lemieur | Surgery | 320 E Main St, Cuyuna Regional Medical Center, Crosby, MN 56441-1645 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033725197 | Advanced Surgical Associates of Northern Minnesota LLC | Surgery | 4325 9th Ave W, Hibbing, MN 55746-3032 | 2020-09-23 |
| 1518512680 | Loay Aljaberi | Surgery | Mayo Clinic 200 1st Sw, Rochester, MN 55905-0001 | 2019-08-06 |
| 1073021077 | Alton John Olson | Surgery | 7008 - Morgan Avenue South, Richfield, MN 55423 | 2018-01-12 |
| 1760993745 | Allina Health System | Surgery | 920 E 28th St Ste 540, Minneapolis, MN 55407-1134 | 2017-10-18 |
| 1669836268 | Erinn Afflick | Surgery | 200 1st South St, Rochester, MN 55905-0001 | 2016-04-09 |
| 1063899250 | Andrew Bergersen | Surgery | 3366 Oakdale Ave N Ste 303, Robbinsdale, MN 55422-2977 | 2015-04-27 |
| 1619362001 | Sean Luke Peterson | Surgery | 9 W Franklin Ave Apt 306, Minneapolis, MN 55404-2594 | 2015-04-02 |
| 1699173716 | Caliann Tsuitsin Lum | Surgery | 110 Bank St Se Apt 904, Minneapolis, MN 55414-3903 | 2014-12-06 |
| 1972920338 | Emily Rapstine Bond | Surgery | 420 Delaware St Se # 207, Minneapolis, MN 55455 | 2014-03-24 |
| 1518200914 | Jessica Shaheen | Surgery | 303 E Nicollet Blvd Ste 300, Burnsville, MN 55337 | 2013-04-03 |
| 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.