Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shane Byrn Richardson, MD

Individual provider Family Medicine Physician · NPI 1659710374

Dr. Shane Byrn Richardson, MD is a Family Practice in Cloquet, Minnesota. Qualified in 2011, 15 years ago. Practices with Fond Du Lac Reservation Business Committee, a 40-clinician group and works from 3 locations. Licensed in Arizona and Minnesota.

Years since qualifying
15
Licensed in
AZ, MN
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

927 Trettel Ln
Cloquet, MN 55720-1345
Phone: (218) 879-1227
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 707 N Alvernon Way, Tucson, AZ 85711-1827 — (520) 694-1614
  • 221 W 4th St, Duluth, MN 55806-2719 — (218) 879-1227

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 64730 (MN)
Family Medicine Physician Taxonomy 207Q00000X · Licence R73957 (AZ)

Record details

NPI number1659710374
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 15, 2013
Last updated in NPPESJanuary 29, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Fond Du Lac Reservation Business Committee — 40 clinicians
Accepts Medicare assignment Not indicated

Other providers in Cloquet