Shelley D Overholt-Thiesen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

57858 Issued in MN

Practice address

320 East Main Street
Cuyuna Regional Medical Center
Crosby, MN 56441

Phone

(218) 546-7000

Fax

(218) 546-4400

NPI assigned

Apr 12, 2006

Last updated

Mar 26, 2015By 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

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

Practice roles

Locations

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.

• Family Practice Associates of McPherson, L.L.P.

  • Family Medicine Physician
  • McPherson, KS
  • NPI 1588627384
  NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1922062520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN STREET",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN STREET",
            "address_2": "CUYUNA REGIONAL MEDICAL CENTER",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERHOLT-THIESEN",
        "first_name": "SHELLEY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-29239",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "57858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LICENSE",
            "identifier": "57858",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100404310A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abby Jo Murray, MD
• Trisha B Mykkanen, NP
• Katie Michelle Nystrom, LICSW, MSW
• Rodney S Ogard, CRNA
• Jesse A Oman, APRN,CNP
• Diane Marie Palkert, MD
• Kristin Scherber Patrick, PHARM.D.
• Tonya Paul, PT
• Britta Rae Peterson, APRN, CRNA
• Lauren M Phillips, MD

• Family Medicine Physician in Crosby, MN
• Providers in Crosby, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.