Individual provider Active NPI

John Sheahan

  • Neonatal/Pediatric Registered Respiratory Therapist
  • Roseville, MN
National Provider Identifier
1497898100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal/Pediatric Registered Respiratory TherapistTaxonomy code 2279P3900X
License
2165 Issued in MN
Practice address
2800 Cleveland Ave N
Roseville, MN 55113-1126
Phone
(651) 642-1825
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X 2165 MN Primary
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X 2716 WI

Addresses

Primary practice location

2800 Cleveland Ave N
Roseville, MN 55113-1126

Mailing address

10995 Oak Grove Cir
Unit D
Woodbury, MN 55129-8726

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2165MNMDMarriage & Family Therapist
2716WIMDNeonatal/Pediatric Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497898100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10995 OAK GROVE CIR",
            "address_2": "UNIT D",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551298726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131126",
            "telephone_number": "651-642-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAHAN",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "MN",
            "license": "2165",
            "primary": true
        },
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "WI",
            "license": "2716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, 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.

Verify at the official NPI Registry.