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

Shaun Kennedy, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1407110265

Shaun Kennedy, MD is an Emergency Medicine in Maplewood, Minnesota. Qualified in 2012, 14 years ago. Practices with Highline Emergency Physicians PLLC, a 19-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
14
Licensed in
MN
In the registry since
2012
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1575 Beam Ave
Maplewood, MN 55109-2502
Phone: (651) 232-7348
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 640 Jackson St # Mc1102f, Saint Paul, MN 55101-2502 — (651) 254-3666

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 59164 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (MN)

Record details

NPI number1407110265
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 26, 2012
Last updated in NPPESJuly 21, 2022
Mailing address800 East 28th St Mr 11112, Minneapolis, MN 55407

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Highline Emergency Physicians Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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