DR. KENNETH JAMES SHEA III (NPI# 1881855187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881855187 |
Entity Type | Individual |
Full Name | DR. KENNETH JAMES SHEA III |
Credential | M.D. |
Practice Address |
3540 17th Ave S Saint Cloud MN 56301-9664 |
Practice Telephone | 3207662680 |
Mailing Telephone | 3207662680 |
Enumeration Date | 2008-06-19 |
Last Update Date | 2015-12-10 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
57322 | MN | Allopathic & Osteopathic Physicians |
N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
57322 | MN | Allopathic & Osteopathic Physicians |
Street Address |
3540 17TH AVE S |
City | SAINT CLOUD |
State | MN |
Zip Code | 56301-9664 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
1316453442 | Amber Grengs | Behavior Technician | 3721 23rd St S Ste 201, Saint Cloud, MN 56301 | 2017-12-27 |
1124532999 | Ashley Aune Lewandowski | Chiropractor | 3333 W. Division St. Suite 122a, St. Cloud, MN 56301 | 2017-11-30 |
1962923680 | Inspired By You Home Care, LLC | Home Health | 2700 1st Street N, Suite 202, St Cloud, MN 56301 | 2017-07-03 |
1487189569 | Brett Finberg | Pharmacy Technician | 141 33rd Ave South, Saint Cloud, MN 56301 | 2017-04-26 |
1629513221 | Robert Schug | Pharmacy Technician | 141 33rd Ave S, Saint Cloud, MN 56301 | 2017-01-05 |
1649726910 | Rebecca Hoffman Pllc | Specialist | 3400 1st Street N, Suite 300, St. Cloud, MN 56301 | 2016-08-28 |
1558728600 | Language Partners | Interpreter | 400 1st St S, Suite 600, St. Cloud, MN 56301 | 2016-01-20 |
1679981856 | Quality Homecare Services Inc | Home Health | 3450 W Germain St, Ste 206, St Cloud, MN 56301 | 2014-07-31 |
1063759546 | Grand St Paul Cvs, LLC | Durable Medical Equipment & Medical Supplies | 2420 Division St, St. Cloud, MN 56301 | 2013-01-03 |
Find all providers in zip 56301 |
Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861807786 | Nudrat Tasneem | Psychiatry & Neurology | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2014-06-30 |
1083976195 | Leah Ann Thronaum | Psychiatry & Neurology | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2012-06-14 |
1528157500 | Leanore Miriam Simon | Psychiatry & Neurology | 1200 6th Ave N, Centracare Clinic, Saint Cloud, MN 56303-2735 | 2006-10-11 |
1689782765 | Elizabeth A Fernandez | Psychiatry & Neurology | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2006-08-28 |
1184677445 | Pushp Raj Kapoor | Psychiatry & Neurology | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2006-05-18 |
1467433409 | Belen O Dy | Psychiatry & Neurology | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2005-11-08 |
1497746648 | Anh X Nguyen | Psychiatry & Neurology | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2005-11-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851905251 | Nexus | Psychiatry & Neurology | 2121 Campus Dr Se, Rochester, MN 55904-4744 | 2020-09-02 |
1669995528 | Malik Ghannam | Psychiatry & Neurology | 701 15th Ave Se, Minneapolis, MN 55414-4047 | 2017-07-24 |
1477903995 | James Albert Zeese Jr. | Psychiatry & Neurology | 2401 Laurel Avenue, Minneapolis, MN 55405 | 2016-06-15 |
1265790414 | Brian Michael Krasnow | Psychiatry & Neurology | 1746 Hillcrest Avenue, Saint Paul, MN 55116-2151 | 2012-04-25 |
1699079533 | Gilbert Westreich | Psychiatry & Neurology | 1779 Emerson Ave South, Minneapolis, MN 55403-2909 | 2011-01-07 |
1720233570 | West Central Neurology Pa | Psychiatry & Neurology | 11521 312th Ave, Princeton, MN 55371-3423 | 2008-11-20 |
1235388521 | Donald W Klass | Psychiatry & Neurology | 956 14th Ave Sw, Rochester, MN 55902-2078 | 2008-09-11 |
1598929267 | Frank Wilson Sharbrough IIi | Psychiatry & Neurology | 814 8th Ave Sw, Rochester, MN 55902-6308 | 2008-07-11 |
1275792293 | Ali Emami | Psychiatry & Neurology | 310 Smith Ave N Ste 440, Saint Paul, MN 55102-2316 | 2008-06-05 |
1174718027 | Roberta Ruth Hallquist | Psychiatry & Neurology | 2812 E Superior St, Duluth, MN 55812-2345 | 2007-09-12 |
Find all providers with the same taxonomy |
City | SAINT CLOUD |
Zip Code | 56301 |
Please comment or provide details below to improve the information on DR. KENNETH JAMES SHEA III.
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.