Alexis Shock, STUDENT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

401 Demers Ave
East Grand Forks, MN 56721-1835

Phone

(218) 779-0134

NPI assigned

Aug 11, 2021

Last updated

Aug 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1518632520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5073 W ELM CT",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582030606",
            "telephone_number": "701-367-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211835",
            "telephone_number": "218-779-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCK",
        "first_name": "ALEXIS",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nirchet Singh Sidhu, M.D.
• Paige Nicole Simonson
• Caitlin Sisson, MD
• Michele A Spiekermeier, NP

• Professional Counselor in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.