MR. KENT SHANNON WILSON


Address: 2080 Woodwinds Drive, #120, Woodbury, MN 55125
Phone: 6517020750

MR. KENT SHANNON WILSON (NPI# 1922044288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922044288
Entity Type Individual
Full Name MR. KENT SHANNON WILSON
Credential MD
Practice Address 2080 Woodwinds Drive
#120
Woodbury
MN 55125
Practice Telephone 6517020750
Practice Fax Number 6517020749
Mailing Telephone 6517020750
Mailing Fax Number 6516456166
Enumeration Date 2006-06-22
Last Update Date 2009-12-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology 17805 MN Allopathic & Osteopathic Physicians
N 208600000X Surgery 17805 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 905070100 05

Other Providers KENT WILSON

NPI Name Taxonomy Address Enumeration
1700208576 Kent William Wilson Dentist 1941 Huntington Dr, Suite B, South Pasadena, CA 91030-4967 2014-01-14
1003167743 Kent A Wilson Psychologist 2460 W 26th Ave Ste 10-c, Denver, CO 80211-5308 2012-09-20
1073523965 Kent J Wilson Speech-Language Pathologist 3601 S 6th Ave, Tucson, AZ 85723-0001 2006-08-09
1013924364 Kent A. Wilson Optometrist 808 W Moore Ave, Suite B, Terrell, TX 75160-3002 2006-08-01

Office Location

Street Address 2080 WOODWINDS DRIVE
#120
City WOODBURY
State MN
Zip Code 55125

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790721124 Jodie Lynn Mensink Audiologist 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22
1841503182 Caitlin Ariel Turriff Audiologist 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2010-07-15
1720151608 Cherie Yvonne Zachary Allergy & Immunology 2080 Woodwinds Drive, Suite #240, Woodbury, MN 55125 2006-11-16
1114943222 Thomas Luke Okner Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-07-14
1295771558 Victor Stuart Cox Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22
1104862465 Robert Weston Smith Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22
1013953371 Richard G Karlen Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22
1831135193 Barbara Newman Malone Otolaryngology 2080 Woodwinds Drive, #120, Woodbury, MN 55125 2006-06-22
1043256357 Christopher John Tolan Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1487268728 Haley Kirkpatrick Behavior Technician 721 Commerce Dr., Woodbury, MN 55125 2020-09-03
1689218091 Jordan Schmidt Student in an Organized Health Care Education/Training Program 1740 Welr Dr. #24, Woodbury, MN 55125 2019-10-30
1629619580 Mackenzie Ann Funke Occupational Therapist 721 Commerce Drivve, Woodbury, MN 55125 2019-10-02
1700342029 Darcy Stivland Counselor 1811 Weir Drive #270, Woodbury, MN 55125 2019-02-11
1235609884 Elizabeth Kennedy Ward Psychologist 7582 Currell Blvd Suite 208, Woodbury, MN 55125 2018-11-27
1528573664 Cory Lee Baumeister Counselor 652 Bielenberg Dr, Woodbury, MN 55125 2017-12-12
1760918239 David James Knight Dentist 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 2017-05-03
1366988826 Mark Your Home Health Care LLC Home Health 6053 Hudson Road, Suite 200, Woodbury, MN 55125 2017-01-09
1518415736 Kubei Holdings Group LLC Case Management 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 2016-09-16
1285087072 Adrian Jung Occupational Therapist 155 Radio Drive, Woodbury, MN 55125 2016-07-18
Find all providers in zip 55125

Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881007250 David A Temmermand Otolaryngology 620 North Broad Street, Woodbury, NJ 08096 2014-06-03
1457307316 Kristin Gendron Otolaryngology 2080 Woodwinds Drive #240, Woodbury, MN 55125 2006-05-25
1831162601 Geoffrey J Service Otolaryngology 2080 Woodwinds Dr Ste 240, Woodbury, MN 55125-2539 2006-02-10
1487093399 Daniel John-martin Carroll Otolaryngology 2080 Woodwinds Dr Ste 240, Woodbury, MN 55125-2539 2013-06-25
1144451691 Jamie Katherine Flohr Otolaryngology 2080 Woodwinds Dr Ste 240, Woodbury, MN 55125-2539 2009-07-31
1326169160 Garrett R Griffin Otolaryngology 2080 Woodwinds Dr, Suite 120, Woodbury, MN 55125 2007-04-02
1821195959 Otolaryngology Head & Neck Surgery, P.a. Otolaryngology 2080 Woodwinds Dr, #240, Woodbury, MN 55125 2006-09-20
1114943222 Thomas Luke Okner Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-07-14
1578509832 Eric Thomas Becken Otolaryngology 2080 Woodwinds Dr Ste 240, Woodbury, MN 55125 2006-06-22
1295771558 Victor Stuart Cox Otolaryngology 2080 Woodwinds Drive, #240, Woodbury, MN 55125 2006-06-22
Find all providers in WOODBURY

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City WOODBURY
Zip Code 55125

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Dataset Information

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.

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