Shonalie Leville, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

49177 Issued in MN

Practice address

501 E Nicollet Blvd
Ste 200
Burnsville, MN 55337-6732

Phone

(952) 898-5900

Fax

(952) 278-6947

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659417210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PARKLAWN AVE",
            "address_2": "STE 120",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355655",
            "telephone_number": "952-831-1944",
            "fax_number": "952-278-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E NICOLLET BLVD",
            "address_2": "STE 200",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376732",
            "telephone_number": "952-898-5900",
            "fax_number": "952-278-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVILLE",
        "first_name": "SHONALIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "49177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "FP9021048582",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1213786",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elle Lemler
• Ann E Lenarz, M.A., LMFT
• Lisa Leon, MA, LMFT
• Justin David Less, LICSW
• Ryane Leigh Lester, PA-C
• Levine-Adler P.a.
• Casey Lewandoski, ATC, LAT
• Leah Lewis
• Moria Lewis
• Randall Alfred Lewis, M.D.

• Pediatrics Physician in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Pediatrics Physician in Minnesota

• 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.