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NPI Code Detail

MEDICARE: MISS SHANNON MARIE BUCKMIER PT

MEDICARE: MISS SHANNON MARIE BUCKMIER PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical Therapist980ND
22251P0200XPediatric Physical Therapist6742MN
3225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164-05521OTHERMEDICA-UNITED HEALTH CARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3HP50727OTHERHEALTH PARTNERS
425303OTHERNDBLUE CROSS BLUE SHIELD
564-05521OTHERAETNA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
79378588OTHERPRIVATE HEALTHCARE SYSTEM

General Provider Information

NPI Number : 1922155043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SHANNON MARIE BUCKMIER PT
Provider Business Mailing Address
First Line : 3244 51ST ST S
Second Line :
City : FARGO
State : ND
Zip : 58104-7179
Country : US
Telephone Number : 13-565-4127
Fax Number : 701-356-5412
Provider Business Practice Location Address
First Line : 3244 51ST ST S
Second Line :
City : FARGO
State : ND
Zip : 58104-7179
Country : US
Telephone Number : 13-565-4127
Fax Number : 701-356-5412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 04/30/2025

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Directions to “ MISS SHANNON MARIE BUCKMIER PT” Practice Location

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