Individual provider Active NPI

Shannon Tomfohrde, M.D.

  • Emergency Medicine Physician
  • Stillwater, MN
National Provider Identifier
1871942771
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
65442 Issued in MN
Practice address
927 Churchill St W
Stillwater, MN 55082-6605
Phone
(651) 430-4529
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23147 WI
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 65442 MN Primary

Addresses

Primary practice location

927 Churchill St W
Stillwater, MN 55082-6605

Mailing address

640 Jackson St
Saint Paul, MN 55101-2502

Other practice location 1

301 2nd St NE
New Prague, MN 56071-1709
Phone (952) 758-4431

Other practice location 2

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (952) 853-8800

Other practice location 3

3930 Northwoods Dr
Arden Hills, MN 55112-6963
Phone (952) 853-8800

Other practice location 4

405 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000

Other practice location 5

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3666

Other practice location 6

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (952) 853-8800

Other practice location 7

205 Wabasha St S
Saint Paul, MN 55107-1805
Phone (952) 853-8800

Other practice location 8

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190604001141 MN Practitioner - Emergency Medicine 5597052530 Reassigns benefits to 3 organizations
I20221221001503 WI Practitioner - Emergency Medicine 5597052530 Reassigns benefits to 9 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23147WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Regional Medical Center CurrentSince Nov 1, 2022 Accepting new patients
Regions Hospital CurrentSince Jan 9, 2023 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Regions Hospital Emergency Medicine CurrentSince Jan 9, 2023 Accepting new patients
Hudson Hospital, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Group Health, Inc. CurrentSince Mar 30, 2023 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Group Health, Inc. CurrentSince Mar 30, 2023 Accepting new patients
St. Croix Regional Medical Center CurrentSince Nov 1, 2022 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Lakeview Memorial Hospital Association Inc. Emergency Medicine CurrentSince Jan 9, 2023 Accepting new patients
Lakeview Memorial Hospital Association Inc CurrentSince Jan 9, 2023 Accepting new patients
Westfields Hospital, Inc CurrentSince Jan 9, 2023 Accepting new patients
Hudson Hospital, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Group Health, Inc. Current Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 26, 2025 Accepting new patients
Hudson Hospital, Inc Past Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Past Accepting new patients
Amery Regional Medical Center, Inc. Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

1500 Curve Crest Blvd W
Stillwater, MN 55082

8450 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5300

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Organizations & group practices 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1871942771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 CHURCHILL ST W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826605",
            "telephone_number": "651-430-4529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 2nd St NE",
            "address_purpose": "LOCATION",
            "city": "New Prague",
            "state": "MN",
            "postal_code": "560711709",
            "country_code": "US",
            "telephone_number": "952-758-4431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8450 Seasons Pkwy",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551254402",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3930 Northwoods Dr",
            "address_purpose": "LOCATION",
            "city": "Arden Hills",
            "state": "MN",
            "postal_code": "551126963",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Stageline Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-3666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Como Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551081460",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Wabasha St S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551071805",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WI",
            "postal_code": "540171449",
            "country_code": "US",
            "telephone_number": "715-243-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMFOHRDE",
        "first_name": "SHANNON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "23147",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "65442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.