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

Dr. Keith Wayne Fridel, PHD

Individual provider Psychologist · NPI 1215345244

Dr. Keith Wayne Fridel, PHD is a Clinical Psychologist in Shakopee, Minnesota. Qualified in 2011, 15 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
15
Licensed in
IL
In the registry since
2014
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone: (952) 993-7750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10640 165th St, Orland Park, IL 60467-8734 — (708) 364-0261

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 071008852 (IL)

Record details

NPI number1215345244
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJuly 22, 2014
Last updated in NPPESMarch 17, 2018

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Shakopee