Shannon Medenwald, RD is a
Dietitian, Registered based in Brookings, South Dakota. Shannon Medenwald is licensed to practice in South Dakota (license number 0419) and her current practice location is
300 22nd Ave, Brookings, South Dakota. She can be reached at her office (for appointments etc.) via phone at
(605) 696-9000.
NPI number for Shannon Medenwald is 1144598889 and her current mailing address is 4415 Calico Dr S, Apt 303, Fargo, North Dakota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1144598889.
Healthcare Provider's Profile
| Full Name | Shannon Medenwald |
|---|
| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 300 22nd Ave, Brookings, South Dakota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1144598889
- Provider Enumeration Date: 12/08/2011
- Last Update Date: 12/08/2011
Medical Identifiers
Medical identifiers for Shannon Medenwald such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144598889 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 0419 (South Dakota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon Medenwald is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shannon Medenwald, RD
4415 Calico Dr S, Apt 303,
Fargo, ND 58104-8744
Ph: (701) 200-7233 | Shannon Medenwald, RD
300 22nd Ave,
Brookings, SD 57006-2480
Ph: (605) 696-9000 |
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