Kyle Shipley Diagnostic Radiology
166 E 4th St, Suite 100, St Paul, MN 55101-1421


Kyle Shipley is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1841408200. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 6507995339. The primary specialty is DIAGNOSTIC RADIOLOGY. The organization is PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION. The address is 166 E 4th St, Suite 100, St Paul, MN 55101-1421. The zip code is 55101.


Kyle Shipley · 166 E 4th St, Suite 100, St Paul, MN 55101-1421

Nation Provider ID 1841408200
PAC ID by PECOS 6507995339
Professional Enrollment ID I20150521002513
Last Name SHIPLEY
First Name KYLE
Gender M
Medical School Name UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduation Year 2005
Primary Specialty DIAGNOSTIC RADIOLOGY
Primary Specialty PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION
Phone Number 6512922000
Group Practice PAC ID 4789643719
Number of Group Practice Members 56
Address 166 E 4TH ST
SUITE 100
ST PAUL, MN 551011421
Claims Based Hospital Affiliation Claim Control Number (CCN): 240106
Legal Business Name: REGIONS HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 240063
Legal Business Name: ST JOSEPH'S HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 240210
Legal Business Name: HEALTHEAST ST JOHN'S HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 240213
Legal Business Name: HEALTHEAST WOODWINDS HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 240038
Legal Business Name: UNITED HOSPITAL
Professional accepts Medicare Assignment Y
Report Quality Measures Y

Pembina County Memorial Hospital Association · Medicare Physician

Name Address Specialty
Eric Carolan 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Jonathan Phelan 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Robert Weinmann 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Don Wiese 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Kristin Lieberman 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Inder Khokha 301 Mountain St E, Cavalier, ND 58220-4015 GENERAL SURGERY
Laura Ermer 301 Mountain St E, Cavalier, ND 58220-4015 PHYSICIAN ASSISTANT
Benjamin Gilloon 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Joshua Johnson 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Kulvinder Sumra 301 Mountain St E, Cavalier, ND 58220-4015 FAMILY PRACTICE
Alexandra Muschenheim 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Peter Wold 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Lester Fahrner 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY

Zip 55101 · Diagnostic Radiology · Medicare Physician

Name Address Specialty
Kristin Lieberman 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Alexandra Muschenheim 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Anne Weisensee 168 6th St E, St Paul, MN 55101-1947 DIAGNOSTIC RADIOLOGY
Robert Weinmann 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Steven Hommeyer 166 4th St E, Saint Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Peter Wold 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Lester Fahrner 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Joshua Johnson 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Don Wiese 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Ryan Whitesell 166 4th St E, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Eric Carolan 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Jeff Werner 166 4th St E, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Jonathan Phelan 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Thomas Bryson 166 4th St E, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Jeffrey Phelan 166 4th St E, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Frank Maguire 200 E University Ave, Saint Paul, MN 55101-2507 DIAGNOSTIC RADIOLOGY
Richard Aizpuru 166 4th St E, Saint Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Benjamin Gilloon 166 E 4th St, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY
Bruce Berens 166 4th St E, St Paul, MN 55101-1421 DIAGNOSTIC RADIOLOGY

Zip 55101 · Medicare Physician

Name Address Specialty
Christopher Wendell 640 Jackson St, Saint Paul, MN 55101-2502 ANESTHESIOLOGY
Randy Twito 640 Jackson St, Saint Paul, MN 55101-2502 ORTHOPEDIC SURGERY
Patricia Makowski 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Steven Debol 640 Jackson St, Saint Paul, MN 55101-2502 PATHOLOGY
Jessica Wittenberg 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Carol Zerfas 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Robert Wagner 200 E University Ave, Saint Paul, MN 55101-2507 FAMILY PRACTICE
Monica Lucus 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Jodi Peterman 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
William Moss 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Patricia Manser 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Kathleen Omeara 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Kevin Helland 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Carrie Fernandez 640 Jackson St, Saint Paul, MN 55101-2502 OCCUPATIONAL THERAPY
Margaret Keller 640 Jackson St, Saint Paul, MN 55101-2502 OCCUPATIONAL THERAPY
David Niccum 640 Jackson St, Saint Paul, MN 55101-2502 PULMONARY DISEASE
Sarah Wisdom 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Matthew Costain 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Christina Herrmann 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST
Joseph Pruis 640 Jackson St, Saint Paul, MN 55101-2502 CERTIFIED REGISTERED NURSE ANESTHETIST