MR. KONSTANTIN V. SHATSKIKH (NPI# 1346435740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346435740 |
| Entity Type | Individual |
| Full Name | MR. KONSTANTIN V. SHATSKIKH |
| Credential | PA-C |
| Practice Address |
2200 Nw 26th St Owatonna MN 55060 |
| Mailing Address |
2200 Nw 26th St Owatonna MN 55060-5503 |
| Practice Telephone | 5044511120 |
| Mailing Telephone | 5044511120 |
| Enumeration Date | 2007-09-09 |
| Last Update Date | 2020-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10312 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 810 County Road 42 W, Burnsville, MN 55337 | 8153639500 |
| Street Address |
2200 NW 26TH ST |
| City | OWATONNA |
| State | MN |
| Zip Code | 55060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324846 | Sara L. Packard | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2005-05-27 |
| 1275146680 | Jessica K Phelps | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2020-08-25 |
| 1588299804 | Cayla Kathleen Witte | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2020-03-06 |
| 1457909384 | Aicha Sylvie Katty | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-09-04 |
| 1366091266 | Melanie Kay Busch | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-09-04 |
| 1013576982 | Brady Michael Gross | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-06-13 |
| 1023573193 | Kayla Marie Cook | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-02-04 |
| 1467926618 | Megan Alm | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-01-21 |
| 1356814271 | Mallory Lynn Berry | Family Medicine | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-01-03 |
| 1801313796 | Melinda Louann Wiese | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2017-08-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669936480 | Lee Joseph Bakewell | Nurse Practitioner | 2200 Nw 26th St, Owatonna, Owatonna, MN 55060 | 2019-01-25 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1801326418 | Katharyn Kristin Stricklin | Registered Nurse | 1961 Premier Drive, Suite 340 Mankato, Mankato, MN 55060 | 2017-06-15 |
| 1134666753 | Holly Christianson | Social Worker | 2575 Harvest Lane Nw, Owatonna, MN 55060 | 2017-01-20 |
| 1346613031 | Birchwood Cottages | Assisted Living Facility | 1905 Austin Road, Owatonna, MN 55060 | 2015-11-04 |
| 1881080067 | Cory Michael Kopas | Chiropractor | 130 26th Street Nw, Owatonna, MN 55060 | 2015-04-14 |
| 1528456613 | Quality Home Health Care Inc. | Home Health | 201 East Front Street, Owatonna, MN 55060 | 2014-12-26 |
| 1194017624 | Amy Louise Haycraft | Nurse Practitioner | South Central Human Relations Center, 610 Florence Ave, Owatonna, MN 55060 | 2011-05-02 |
| 1710123971 | Rahn Optometry Inc | Optometrist | 1130 W. Frontage Rd, Owatonna, MN 55060 | 2008-12-18 |
| 1063616993 | Michael John Dickman | Dentist | 1414 S Oak Ave Suite Five, Owatonna, MN 55060 | 2007-06-13 |
| Find all providers in zip 55060 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324846 | Sara L. Packard | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2005-05-27 |
| 1588299804 | Cayla Kathleen Witte | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2020-03-06 |
| 1013576982 | Brady Michael Gross | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-06-13 |
| 1023573193 | Kayla Marie Cook | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-02-04 |
| 1467926618 | Megan Alm | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-01-21 |
| 1255870887 | Brian Maurice Crawley | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2017-02-15 |
| 1548635014 | Kelly Eli Daugherty | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2015-12-09 |
| 1003188004 | Jacob C Kruger | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2012-02-07 |
| 1255535787 | Ashlee Marie Tackmann | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060 | 2007-06-11 |
| 1609909035 | Ashleigh Jean Milbrath | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2007-03-14 |
| Find all providers in OWATONNA | ||||
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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.