SHELBY N KENISON (NPI# 1790020949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790020949 |
| Entity Type | Individual |
| Full Name | SHELBY N KENISON |
| Other Name | SHELBY N VIETZE |
| Credential | ATC |
| Practice Address |
28675 740th Ave Clarks Grove MN 56016-4041 |
| Practice Telephone | 5072133487 |
| Mailing Telephone | 5072133487 |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
2306 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | NPI | 1790020949 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 103 Independence Ave S, Clarks Grove, MN 560167704 | 5072133487 |
| Street Address |
28675 740TH AVE |
| City | CLARKS GROVE |
| State | MN |
| Zip Code | 56016-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710183819 | Diane Vonhagen | Technician | 209 Hillcrest Dr, Clarks Grove, MN 56016-9775 | 2007-06-25 |
| 1750473757 | Joan Stuke | Technician | 329 Hillcrest Cir, Clarks Grove, MN 56016-9776 | 2006-09-28 |
| 1336231414 | Cassandra Krett | Technician | 350 Hillcrest Cir, Clarks Grove, MN 56016-9776 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710183819 | Diane Vonhagen | Technician | 209 Hillcrest Dr, Clarks Grove, MN 56016-9775 | 2007-06-25 |
| 1750473757 | Joan Stuke | Technician | 329 Hillcrest Cir, Clarks Grove, MN 56016-9776 | 2006-09-28 |
| 1336231414 | Cassandra Krett | Technician | 350 Hillcrest Cir, Clarks Grove, MN 56016-9776 | 2006-09-28 |
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| 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 |
| 1902310154 | Dorothy Jane Hanna | Physical Medicine & Rehabilitation | 10939 Quebec Ave N, Champlin, MN 55316-3261 | 2017-11-27 |
| 1932502267 | Kyle Braulick | Physical Medicine & Rehabilitation | 5025 Edinburgh Way, Big Lake, MN 55309-8271 | 2014-10-01 |
| 1770806374 | Kevin Neil Johnson | Physical Medicine & Rehabilitation | 9913 214th St W Ste B, Lakeville, MN 55044-1914 | 2010-03-10 |
| 1962069864 | Allyson Carol Maynard | Physical Medicine & Rehabilitation | 800 Prairie Center Dr Ste 230, Eden Prairie, MN 55344-7308 | 2019-05-26 |
| 1831672492 | Nathaniel Erik Thomsen | Physical Medicine & Rehabilitation | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-09-10 |
| 1023517364 | Hannah Rhiannon Salisbury | Physical Medicine & Rehabilitation | 3900 Bethel Dr, Arden Hills, MN 55112-6902 | 2018-02-01 |
| 1386006682 | Allison Nicole Schroeder | Physical Medicine & Rehabilitation | 200 1st St Sw, Rochester, MN 55905-0001 | 2016-03-25 |
| 1235530890 | Wade Johnson | Physical Medicine & Rehabilitation | 1025 Marsh St, Mankato, MN 56001-4752 | 2014-09-14 |
| 1063758290 | Katherine N Nanos | Physical Medicine & Rehabilitation | 200 1st St Sw, Rochester, MN 55905-0001 | 2012-12-16 |
| Find all providers with the same taxonomy | ||||
| City | CLARKS GROVE |
| Zip Code | 56016 |
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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.