Neuro PLLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

NEURO PLLC

Practice address

15600 36TH Ave N Ste 140
Plymouth, MN 55446-3372

Phone

(763) 308-5772

Fax

(612) 392-7974

NPI assigned

Aug 1, 2022

Last updated

Aug 1, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Odland, PHD, LP, ABPPNPI 1669853099

Title

Owner/Ceo

Phone

(320) 491-8233

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Odland, PHD, LP, ABPP

  • Clinical Neuropsychologist
  • Plymouth, MN
  • NPI 1669853099
  Medicare reassignment NPD Authorized official
• Hannah Louise Weiss, PHD

  • Clinical Neuropsychologist
  • Plymouth, MN
  • NPI 1295624559
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1003542069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 36TH AVE N STE 140",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463372",
            "telephone_number": "320-491-8233",
            "fax_number": "612-392-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 36TH AVE N STE 140",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463372",
            "telephone_number": "763-308-5772",
            "fax_number": "612-392-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-07-31",
        "status": "A",
        "authorized_official_last_name": "ODLAND",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "320-491-8233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP, ABPP"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@neuromn.com",
            "affiliation": "N",
            "address_1": "15600 36th Ave N Ste 140",
            "city": "Plymouth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554463372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Elizabeth Ness, MD
• Mollie Kae Ness, CNP, FNP-C
• Olivia Ness
• Polly A Nesset, NP
• Heidi Neubauer, ND
• Lindsay Marie Neutkens, PA-C
• Oscar Nevermann, DPT
• New Living LLC
• Louis Newstrom, LMT
• Katherine M Newton, PH.D., L.P.

• Clinical Neuropsychologist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Clinical Neuropsychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.