DR. SHANNON MARIE MACKEY-BOJACK (NPI# 1194745174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194745174 |
| Entity Type | Individual |
| Full Name | DR. SHANNON MARIE MACKEY-BOJACK |
| Credential | M.D. |
| Practice Address |
333 Smith Ave N Room 4625 Saint Paul MN 55102-2344 |
| Mailing Address |
333 Smith Ave N Rm 4625 Saint Paul MN 55102-2344 |
| Practice Telephone | 6512415568 |
| Practice Fax Number | 6512417114 |
| Mailing Telephone | 6512415568 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-02-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
43421 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
333 SMITH AVE N ROOM 4625 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55102-2344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316930456 | Jorge Antonio Ferreiro | Pathology | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2005-08-24 |
| 1487278214 | Rachel Rubatt | Dietitian, Registered | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-06-08 |
| 1831712439 | Anna Dittmann | Registered Nurse | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-05-19 |
| 1710508270 | Lisa Anne Paradiso | Dietitian, Registered | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-05-06 |
| 1467073718 | Michelle Schierts | Speech-Language Pathologist | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-04-28 |
| 1629607254 | Salvum Anesthesia | Nurse Anesthetist, Certified Registered | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-04-06 |
| 1316575137 | Michelle Bencriscutto-synstelien | Registered Nurse | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-03-28 |
| 1235765611 | Lexi Mae Ternes | Registered Nurse | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-03-18 |
| 1154954717 | Jenna Marie Benzinger Tabet | Registered Nurse | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-02-21 |
| 1932732252 | Brian Charles Nye | Nurse Anesthetist, Certified Registered | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2020-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013337773 | Kevin Jee Ha | Pathology | 172 6th St E Apt 1906, Saint Paul, MN 55101-1978 | 2014-04-22 |
| 1316930456 | Jorge Antonio Ferreiro | Pathology | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2005-08-24 |
| 1447538301 | Maryna Tarbunova | Pathology | 640 Jackson St, Saint Paul, MN 55101-2502 | 2011-07-26 |
| 1811187065 | Maria Ramos Stitzel | Pathology | 640 Jackson St, Saint Paul, MN 55101 | 2007-07-25 |
| 1255541223 | Shannon M. Gabriel-griggs | Pathology | 640 Jackson St, Saint Paul, MN 55101-2502 | 2007-05-22 |
| 1730396946 | Sarah Elizabeth Henry | Pathology | 640 Jackson St, Saint Paul, MN 55101-2502 | 2007-05-17 |
| 1699789883 | Steven M Debol | Pathology | 640 Jackson St, Saint Paul, MN 55101 | 2006-07-27 |
| 1396711321 | Douglas Arlo Olson | Pathology | 640 Jackson St, Mc 11103e, Saint Paul, MN 55101 | 2006-02-28 |
| 1992771141 | Janet S Beneke | Pathology | 640 Jackson St, Mc 11103e, Saint Paul, MN 55101-2502 | 2006-02-27 |
| 1245205186 | Amarnath Subramanian | Pathology | 640 Jackson St, Mc 11103e, Saint Paul, MN 55101-2502 | 2006-02-22 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55102 |
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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.