Active NPI
Lloyd E Rootes, LP, PHD
- Psychologist
- Bemidji, MN
National Provider Identifier
1003037490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP2737
- Practice address
- 514 Beltrami Ave NW
Bemidji, MN 56601-3010 - Phone
- (218) 444-2845
- Fax
- (218) 444-2847
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP2737 | MN | Primary |
Addresses
Primary practice location
514 Beltrami Ave NW
Bemidji, MN 56601-3010
Mailing address
514 Beltrami Ave NW
Bemidji, MN 56601-3010
Phone (218) 444-2845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163M9RO | Other | MN | BLUE CROSS BLUE SHIELD MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP2737 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003037490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 BELTRAMI AVE NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566013010",
"telephone_number": "218-444-2845",
"fax_number": "218-444-2847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 BELTRAMI AVE NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566013010",
"telephone_number": "218-444-2845",
"fax_number": "218-444-2847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOTES",
"first_name": "LLOYD",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "LP, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP2737",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MN",
"identifier": "163M9RO",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.