SREELATHA S SPIEKER (NPI# 1619956620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619956620 |
| Entity Type | Individual |
| Full Name | SREELATHA S SPIEKER |
| Credential | MD |
| Practice Address |
1400 Madison Ave.madison East Center Suite 352 Mankato Clinic Department of Psychiatry Mankato MN 56001 |
| Mailing Address |
Po Box 8674 1230 E Main St Mankato Clinic Ltd Mankato MN 56002-8674 |
| Practice Telephone | 5073873195 |
| Mailing Telephone | 5076251811 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
47784 | MN | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
47784 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | MEDICAID | 0596627 | 01 |
| MN | 004132700 | 05 | |
| MN | UCARE | 136439 | 01 |
| BCBSM | 214P3SP | 01 | |
| MN | AMERICAS PPO | 2365802 | 01 |
| MN | HEALTH PARTNERS | HP53201 | 01 |
| PREFFERED ONE | NA2951044076 | 01 |
| Street Address |
1400 MADISON AVE.MADISON EAST CENTER SUITE 352 MANKATO CLINIC DEPARTMENT OF PSYCHIATRY |
| City | MANKATO |
| State | MN |
| Zip Code | 56001 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952945180 | Pathways Autism Center LLC | Psychiatry & Neurology | 2021 E Hennepin Ave Ste 155, Minneapolis, MN 55413-1772 | 2019-10-31 |
| 1841514734 | Sara Jean Polley | Psychiatry & Neurology | 5500 94th Ave N, Brooklyn Park, MN 55443-1992 | 2010-03-21 |
| 1356597041 | Wei Guan | Psychiatry & Neurology | 3800 Park Nicollet Blvd Ste 650, St Louis Park, MN 55416-2527 | 2008-08-13 |
| 1831357219 | Lawrence John Young Jr. | Psychiatry & Neurology | 800 E 28th St, Ste. 600, Wasie Bldg., Minneapolis, MN 55407-3723 | 2008-06-02 |
| 1396885646 | Muhammad Waqar Azeem | Psychiatry & Neurology | 11705 State Ave, Brainerd, MN 56401-7307 | 2007-02-07 |
| 1295894269 | Roy Dewayne Hankins | Psychiatry & Neurology | 2558 271 Ave, Madison, MN 56256 | 2006-12-06 |
| 1548345655 | Anupama Chauhan | Psychiatry & Neurology | 13603 80th Cir N, Maple Grove, MN 55369-8961 | 2006-10-26 |
| 1891884326 | Highland Psychiatric Services Pa | Psychiatry & Neurology | 897 St Paul Ave, St Paul, MN 55116 | 2006-10-12 |
| 1427144815 | Adam Fox | Psychiatry & Neurology | 15 Groveland Ter Ste 201, Minneapolis, MN 55403-1154 | 2006-10-05 |
| 1831280635 | Jacob Kerbeshian | Psychiatry & Neurology | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2006-09-27 |
| 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.