Individual provider Active NPI

Shannon Michelle Bakshian, CNP

  • Women's Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1598072761
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3276 Issued in MN
Practice address
1965 Ford Pkwy
Saint Paul, MN 55116-1923
Phone
(651) 696-5640
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R 153459-1 MN
Women's Health Nurse Practitioner 363LW0102X 3276 MN Primary

Addresses

Primary practice location

1965 Ford Pkwy
Saint Paul, MN 55116-1923

Mailing address

5718 Village Creek Pkwy N
Minneapolis, MN 55443-3149
Phone (612) 743-1668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000516 MN Practitioner - Nurse Practitioner 4789869694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3276MNMDChiropractor
R 153459-1MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Feb 7, 2011 Accepting new patients

Locations

7532 Brooklyn Blvd
Minneapolis, MN 55443
Phone (763) 560-1555

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

Interoperability endpoints

  • Direct secure messaging: shannon.bakshian.p1@direct.bridgehcp.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1598072761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 VILLAGE CREEK PKWY N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554433149",
            "telephone_number": "612-743-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161923",
            "telephone_number": "651-696-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSHIAN",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 153459-1",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "3276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.