SHANNON MARIE GUCK (NPI# 1720521818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720521818 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE GUCK |
| Credential | PA-C |
| Practice Address |
1000 Coney St W Perham MN 56573-2102 |
| Mailing Address |
43077 County Highway 53 New York Mills MN 56567-9364 |
| Practice Telephone | 2183471200 |
| Mailing Telephone | 2183715555 |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2019-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 12331 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1000 CONEY ST W |
| City | PERHAM |
| State | MN |
| Zip Code | 56573-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982913505 | Illene T Reed | Family Medicine | 1000 Coney St W, Perham, MN 56573-2102 | 2006-05-05 |
| 1174001648 | Jodie Trites | Pharmacist | 1000 Coney St W, Perham, MN 56573-2102 | 2018-08-06 |
| 1649774670 | Colleen Ann Bauck | Registered Nurse | 1000 Coney St W, Perham, MN 56573-2102 | 2018-03-23 |
| 1770090094 | Amanda Carol Houghtaling | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2018-01-08 |
| 1467971572 | Rose Marie Mader | Registered Nurse | 1000 Coney St W, Perham, MN 56573-2102 | 2017-09-11 |
| 1134656994 | Matthew David Haugen | Family Medicine | 1000 Coney St W, Perham, MN 56573-2102 | 2017-05-11 |
| 1962854646 | Rayna Bergseth | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2016-07-06 |
| 1821403635 | Kevin Dale Swenson | Physician Assistant | 1000 Coney St W, Perham, MN 56573-2102 | 2014-07-01 |
| 1972918472 | Melinda Kay Anderson | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2014-06-24 |
| 1528485877 | Perham Hospital District | Non-Pharmacy Dispensing Site | 1000 Coney St W, Perham, MN 56573-2102 | 2014-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558630012 | Perham Hospital District | Durable Medical Equipment & Medical Supplies | 1000 Coney Street West, Perham, MN 56573 | 2011-12-29 |
| 1730239385 | Dr. Kelvin K. Salathe, P.C. | Chiropractor | 101 West Coney St, Perham, MN 56573 | 2007-01-12 |
| 1124106299 | Langen Family Chiropractic, P.a. | Chiropractor | 108 Market Dr., Perham, MN 56573 | 2006-11-02 |
| 1285710335 | James Odin Langen | Chiropractor | 108 Market Drive, Perham, MN 56573 | 2006-10-31 |
| 1578572202 | Michael L Hamann | Dentist | 200 1st Ave S, Perham, MN 56573 | 2006-08-05 |
| 1033133517 | Timothy Charles Neitzke | Optometrist | 340 Fox St, Perham, MN 56573 | 2006-07-27 |
| 1023063757 | Shopko Stores Operating Co LLC | Pharmacy | 300 Jake St, Perham, MN 56573 | 2006-05-23 |
| 1164917233 | Katlin Larson | Behavior Technician | 735 3rd St Sw, Perham, MN 56573 | 2018-06-29 |
| 1104029347 | Tammy L Sturdevant | Dentist | 335 4th Ave, Perham, MN 56573 | 2007-06-06 |
| 1861610131 | Minnesota Eyecare Network Inc. | Eyewear Supplier (Equipment, not the service) | 340 Fox Street, Perham, MN 56573 | 2007-04-23 |
| Find all providers in zip 56573 | ||||
| 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 |
|---|---|---|---|---|
| 1588265284 | Foua Vang | Physician Assistant | 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 | 2020-11-08 |
| 1043811870 | Leiah Hoffman | Physician Assistant | 4243 Timberridge Ln Apt A, Hermantown, MN 55811-4047 | 2020-11-06 |
| 1760083059 | Amanda Hanover | Physician Assistant | 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 | 2020-11-04 |
| 1780284844 | Lily Ganz | Physician Assistant | 2737 Huntington Ave, St Louis Park, MN 55416-3917 | 2020-10-28 |
| 1972103000 | Jaclyn Ann Bautch | Physician Assistant | 24721 State Highway 15, Saint Augusta, MN 56301-9211 | 2020-10-28 |
| 1801496047 | Tanner Vaughn Kramp | Physician Assistant | 3450 Wild Turkey Rd, Red Wing, MN 55066-1762 | 2020-10-27 |
| 1497354955 | Sarah Marti | Physician Assistant | 810 Thornton St Se Apt 904, Minneapolis, MN 55414-3652 | 2020-10-25 |
| 1598364473 | Kylee N Persing | Physician Assistant | 10 4th Ave S, Saint Cloud, MN 56301-3614 | 2020-10-21 |
| 1073112009 | Reece Edward Mcevoy | Physician Assistant | 2638 Sand Trap Rd Se, Rochester, MN 55904-3904 | 2020-10-21 |
| 1679189021 | Anne Elizabeth Drabot | Physician Assistant | 4741 Vincent Ave S, Minneapolis, MN 55410-1843 | 2020-09-21 |
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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.