JACOB KERBESHIAN (NPI# 1831280635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831280635 |
| Entity Type | Individual |
| Full Name | JACOB KERBESHIAN |
| Credential | MD |
| Practice Address |
111 Hundertmark Rd Ste 205n Chaska MN 55318-1586 |
| Mailing Address |
9400 Zane Ave N Brooklyn Park MN 55443-1814 |
| Practice Telephone | 9529031350 |
| Practice Fax Number | 9524263856 |
| Mailing Telephone | 7637628800 |
| Mailing Fax Number | 7633156685 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
26652 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
111 HUNDERTMARK RD STE 205N |
| City | CHASKA |
| State | MN |
| Zip Code | 55318-1586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473990 | Nathaniel Martin Shields | Counselor | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2020-10-08 |
| 1861909012 | Sarah Tague | Registered Nurse | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2018-01-09 |
| 1982132205 | Nicole Melson | Counselor | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2017-05-31 |
| 1669925228 | Stephen Dahl | Social Worker | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2016-08-01 |
| 1346622248 | Megan Boyington | Social Worker | 111 Hundertmark Rd Ste 205n, 212 Medical Building, Chaska, MN 55318-1586 | 2015-06-26 |
| 1518354315 | Jeanette Nicole Matthews | Counselor | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2015-04-20 |
| 1649678848 | Amy Louise-vannurden Swingle | Psychologist | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2014-12-21 |
| 1619152097 | Richard Todd Peterson | Psychiatry & Neurology | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2008-01-04 |
| 1508072604 | Kelly Ann Senesac | Marriage & Family Therapist | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548742968 | Elizabeth Ann Root | Counselor | 111 Hundertmark Rd Suite 450, Chaska, MN 55318 | 2018-09-01 |
| 1972002244 | Ruth Ann Plante | Counselor | 510 Chestnut Street Suite 201, Chaska, MN 55318 | 2018-02-01 |
| 1265959795 | Bhatti Gi Surgery Center LLC | Clinic/Center | 1447 White Oak Dr, Chaska, MN 55318 | 2017-08-25 |
| 1194241166 | Five Stars Recovery Center | Clinical Medical Laboratory | 1045 Stoughton Ave., Chaska, MN 55318 | 2017-08-21 |
| 1306383419 | Laurie Ann Sisser | Registered Nurse | 123 W. 3rd Street, Suite #1, Forever Life Home Health Care, Chaska, MN 55318 | 2017-01-26 |
| 1942756671 | David Erlandson | Physical Therapist | 110105 Pioneer Trail, #201, Chaska, MN 55318 | 2016-09-01 |
| 1912319286 | Chaska Commons Dental Group PC | Dentist | 114 Pioneer Trail, Chaska, MN 55318 | 2014-05-21 |
| 1063546620 | Laura Lee Bergjord | Social Worker | 600 East 4th St, Chaska, MN 55318 | 2007-03-15 |
| 1184758740 | Jennifer Ann Mueller | Social Worker | 401 East Fourth Street, Chaska, MN 55318 | 2007-03-15 |
| 1487785234 | The Salvation Army Harbor Light Center Beacon Program | Substance Abuse Rehabilitation Facility | 11065 Village Road, Chaska, MN 55318 | 2007-03-07 |
| Find all providers in zip 55318 | ||||
| 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 |
|---|---|---|---|---|
| 1619152097 | Richard Todd Peterson | Psychiatry & Neurology | 111 Hundertmark Rd Ste 205n, Chaska, MN 55318-1586 | 2008-01-04 |
| 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 |
| 1801836127 | Sanjiv Kumra | Psychiatry & Neurology | 2312 S 6th St, Suite F256/2b W, Minneapolis, MN 55454-1336 | 2006-06-07 |
| 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.