DR. KATHERINE SHIN (NPI# 1336115062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336115062 |
| Entity Type | Individual |
| Full Name | DR. KATHERINE SHIN |
| Credential | MD |
| Practice Address |
101 Willmar Ave Sw Willmar MN 56201 |
| Practice Telephone | 3202315000 |
| Practice Fax Number | 3202315067 |
| Mailing Telephone | 3202315000 |
| Mailing Fax Number | 3202315067 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 42081 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
101 WILLMAR AVE SW |
| City | WILLMAR |
| State | MN |
| Zip Code | 56201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004514 | Gregory M Macik | Optometrist | 101 Willmar Ave Sw, Affiliated Community Medical Centers, Willmar, MN 56201 | 2005-06-28 |
| 1356956601 | Crystal Lynn Fleischhacker | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-09-14 |
| 1730798760 | Katherine Anderson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-07-27 |
| 1861015786 | Madalyn Marie Vohnoutka | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-05-27 |
| 1811526403 | Meagan A Hoflock | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-06 |
| 1124657150 | Carris Health LLC | Clinic/Center | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-02 |
| 1689209900 | Sophie Sharon Reecher | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-03-06 |
| 1285267922 | Kavitha Malango | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-02-21 |
| 1972147858 | Jamie Kalean Erickson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-11-04 |
| 1124660865 | Carris Health LLC | Durable Medical Equipment & Medical Supplies | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-10-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793472 | Sarah Erickson | Counselor | 2120 60th Ave N.w., Willmar, MN 56201 | 2020-09-01 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1154856524 | Mude Transportation Inc | Non-emergency Medical Transport (VAN) | 1712 Monongalia Ave Sw Ap1, Willmar, MN 56201 | 2017-04-24 |
| 1285025874 | Jill Fellows | Occupational Therapist | 611 5th St. Sw, Willmar, MN 56201 | 2015-02-18 |
| 1700294881 | Brenda Wiese | Counselor | 1617 Hwy 12 E, Suite 230, Willmar, MN 56201 | 2014-08-01 |
| 1275955932 | Courtney Regnier | Marriage & Family Therapist | 2320 E Hwy 12 Ste 2, Willmar, MN 56201 | 2014-01-15 |
| 1568732402 | Pamela Jean Kubesh | Social Worker | 328 Sw 3rd Street, Willmar, MN 56201 | 2012-01-10 |
| 1699931824 | Community Behavioral Health Hospital-willmar | Psychiatric Hospital | 1208 Olena Ave Se, Willmar, MN 56201 | 2008-08-07 |
| 1700053345 | Nathan Schrick | Marriage & Family Therapist | 513 Sw 5th Street, Box 1810, Willmar, MN 56201 | 2008-05-13 |
| 1831381680 | Joan M Blonigan Christianson | Chiropractor | 1101 S 1st Street, Willmar, MN 56201 | 2007-08-15 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083823272 | Gregory G. Nelson | Ophthalmology | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2007-05-22 |
| 1104872324 | Ina Drown | Ophthalmology | 1604 1st St S, Willmar, MN 56201 | 2006-05-26 |
| 1720054497 | Timothy R Pieh | Ophthalmology | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290486 | Eye Care Associates, Pa | Ophthalmology | 710 E 24th St Ste 101-201, Minneapolis, MN 55404-3840 | 2018-10-12 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1790228294 | Eye Associates of Central Minnesota Pa | Ophthalmology | 628 Roosevelt Rd, Suite 101, Saint Cloud, MN 56301-4867 | 2016-12-01 |
| 1093160491 | Christina Gillmor | Ophthalmology | 516 Delaware St Se Fl 9, Minneapolis, MN 55455-0356 | 2016-05-04 |
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1467872390 | Luke Dolezal | Ophthalmology | 5851 Duluth St Ste 215, Golden Valley, MN 55422-3956 | 2014-04-17 |
| 1811330939 | James Layer | Ophthalmology | 3708 Upton Ave S, Minneapolis, MN 55410-1237 | 2013-04-08 |
| 1093058158 | Hao Tang | Ophthalmology | 7760 France Ave S Ste 310, Edina, MN 55435 | 2013-03-27 |
| 1407112881 | Phillip Michael Armand Radke | Ophthalmology | 7450 France Ave S Ste 100, Edina, MN 55435-4799 | 2012-04-10 |
| 1023374964 | Sasha Strul | Ophthalmology | 701 25th Ave S Ste 300, Minneapolis, MN 55454-1443 | 2012-04-04 |
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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.