Empowered Kids LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EMPOWERED KIDS LLC

Practice address

4637 Colfax Ave S
Minneapolis, MN 55419-5335

Phone

(612) 204-2003

NPI assigned

Sep 19, 2024

Last updated

Sep 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shannon Meland, CCLS

Title

Certified Child Life Specialist

Phone

(843) 743-5509

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1700613031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4637 COLFAX AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4637 COLFAX AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195335",
            "telephone_number": "612-204-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED KIDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "MELAND",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CERTIFIED CHILD LIFE SPECIALIST",
        "authorized_official_telephone_number": "843-743-5509",
        "authorized_official_credential": "CCLS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.