Shakopee Mdewakanton Sioux Community

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHAKOPEE MDEWAKANTON SIOUX COMMUNITY

Doing business as

Shakopee Dakota Clinic

Practice address

2330 Sioux TRL NW
Prior Lake, MN 55372-9077

Phone

(952) 496-6150

Fax

(952) 233-4224

NPI assigned

Jul 13, 2006

Last updated

Jan 31, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Melaine J Dunlap, CFNP

Title

Health Director

Phone

(952) 496-6151

Specialties & licenses 9

Addresses

Other names 1

• Shakopee Dakota Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Shakopee Mdewakanton Sioux Community

  dba Shakopee Mdewakanton Emergency Services

  • Ambulance
  • Prior Lake, MN
  • NPI 1700890134

  6901861087

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lance P Armstrong, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Shakopee, MN
  • NPI 1003116393

  Single Specialty

  Medicare reassignment NPD
• Scott Arneson, D.C.

  • Chiropractor
  • Edina, MN
  • NPI 1679586663
  Medicare reassignment NPD
• Sara Rae Betterly Wallen

  • Optometrist
  • Prior Lake, MN
  • NPI 1316102643
  Medicare reassignment NPD
• Annette M Collins, DC

  • Chiropractor
  • Prior Lake, MN
  • NPI 1831317163
  Medicare reassignment NPD
• Aleksandr M Giterman, D.C.

  • Chiropractor
  • Bloomington, MN
  • NPI 1992743819
  Medicare reassignment NPD
• Nancy Gail Hawkins, PSY.D.

  • Clinical Psychologist
  • Inver Grove Heights, MN
  • NPI 1568543197
  Medicare reassignment NPD
• Danielle Klick, D.C.

  • Chiropractor
  • Edina, MN
  • NPI 1437581022
  Medicare reassignment NPD
• Erik Thomas Krueger, DPT

  • Physical Therapist
  • Chanhassen, MN
  • NPI 1215576145
  Medicare reassignment NPD
• Sarah Page, DC

  • Chiropractor
  • Mankato, MN
  • NPI 1689125056
  Medicare reassignment NPD
• Emily Yoon Penk-Smith, OTR/L, CLT

  • Occupational Therapist
  • Saint Paul, MN
  • NPI 1720488711
  Medicare reassignment NPD
• Kennedy Grace Schooley, PT

  • Physical Therapist
  • Prior Lake, MN
  • NPI 1760377477
  Medicare reassignment NPD
• Cassandra Stewart, LPCC, LADC

  • Mental Health Counselor
  • Prior Lake, MN
  • NPI 1376432898
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1013933381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SIOUX TRL NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729077",
            "telephone_number": "952-496-6150",
            "fax_number": "952-233-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SIOUX TRL NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729077",
            "telephone_number": "952-496-6150",
            "fax_number": "952-233-4224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15000 Mystic Center Drive",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "55372",
            "country_code": "US",
            "telephone_number": "952-233-2886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2360 Sioux Trl NW",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "553729077",
            "country_code": "US",
            "telephone_number": "952-233-2886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2705 Wozani Ocanku NW",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "55372",
            "country_code": "US",
            "telephone_number": "952-233-2886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHAKOPEE MDEWAKANTON SIOUX COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "MELAINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "952-496-6151",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shakopee Dakota Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott D Carlson
• Troy A Scott, MD
• Raymond Lee Seaburg, D.D.S
• Brianna Marie Seawell, DPT
• Nneka Obiajulu Sederstrom, PHD, MPH, MA
• Shakopee Mdewakanton Sioux Community (Shakopee Mdewakanton Sioux Comm Phcy)
• Shakopee Mdewakanton Sioux Community (Shakopee Mdewakanton Emergency Services)
• Mark Shea
• Shepherds Path Senior Housing,Inc.
• Linda Handelsman Silverman, OT

• Family Medicine Physician in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.