Active NPI
Shawn Laverne Guse, D.C.
- Chiropractor
- Maple Grove, MN
National Provider Identifier
1407930688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3871
- Practice address
- 13704 Grove Dr
Maple Grove, MN 55311-4404 - Phone
- (763) 425-5550
- Fax
- (763) 425-6681
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3871 | MN | Primary |
Addresses
Primary practice location
13704 Grove Dr
Maple Grove, MN 55311-4404
Mailing address
13704 Grove Dr
Maple Grove, MN 55311-4404
Phone (763) 425-5550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6899217 | Other | MN | MN TAX ID # |
| 302M2GU | Other | MN | BCBS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3871 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407930688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13704 GROVE DR",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553114404",
"telephone_number": "763-425-5550",
"fax_number": "763-425-6681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13704 GROVE DR",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553114404",
"telephone_number": "763-425-5550",
"fax_number": "763-425-6681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSE",
"first_name": "SHAWN",
"middle_name": "LAVERNE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "3871",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN TAX ID #",
"identifier": "6899217",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "302M2GU",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.