Shannon Koenig, PT, DPT, CLT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10927 Issued in MN

Practice address

6601 Lyndale Ave S Ste 105
Richfield, MN 55423-2490

Phone

(612) 775-5190

NPI assigned

Dec 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: skoenig413734@excellian.direct.allina.com

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1245878271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 COACHMAN RD APT 387",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 LYNDALE AVE S STE 105",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232490",
            "telephone_number": "612-775-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "SHANNON",
        "credential": "PT, DPT, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-20",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "10927",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westin Jaide Kirk
• Madeline Klaysmat, PA-C
• Michelle Kloke
• Scott Knutson, DPM
• Krista Jean Koehler, DDS
• Katherine Kolbow
• Scott Koltes, D.C.
• Chuechi Jacob Kong, DC
• Kristina Kontras
• Mark W Koppenberg, R.N.

• Physical Therapist in Richfield, MN
• Providers in Richfield, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.