Shannon Evenson, OTR, L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106813 Issued in MN

Practice address

3580 Arcade St
Vadnais Heights, MN 55127-7135

Phone

(651) 968-5201

NPI assigned

Jan 10, 2007

Last updated

Feb 2, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
  • NPI 1306899463
  Medicare reassignment Care Compare group
• Summit Orthopedics, LTD

  • Orthopedic Physical Therapist
  • Saint Paul, MN
  • NPI 1477604320
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1770632507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277135",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Bellinger St",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547035222",
            "country_code": "US",
            "telephone_number": "715-838-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVENSON",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "OTR, L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4439-026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubree Rose Elmquist
• Maren Elze, DPM
• Emergency Physicians Professional Association
• Chelsey A Emery Snaza, LICSW, LADC
• Dayane Escobar Teixeira
• Fairview Pharmacy Services, LLC (Fairview Vadnais Heights Clinic MTM)
• Family Healthservices Minnesota, P.a. (Entira Family Clinics-Vadnais Heights)
• Alyssa Nichole Fee, PA-C
• Joshua C Feeney, DPT
• Danielle Lee Ferkingstad, CRNA

• Occupational Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.