Active NPI
James F Gruba, LP
- Psychologist
- Duluth, MN
National Provider Identifier
1023047404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP0149
- Practice address
- 1401 E 1St St
Duluth, MN 55805-2407 - Phone
- (218) 728-4491
- Fax
- (218) 728-4404
- NPI assigned
- Jun 30, 2006
- 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 | LP0149 | MN | Primary |
Addresses
Primary practice location
1401 E 1St St
Duluth, MN 55805-2407
Mailing address
1401 East First Street
Duluth, MN 55805
Phone (218) 728-4491
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 069248400 | Medicaid | 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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337731200000",
"number": "1023047404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 EAST FIRST STREET",
"city": "DULUTH",
"state": "MN",
"postal_code": "55805",
"telephone_number": "218-728-4491",
"fax_number": "218-728-4404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E 1ST ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558052407",
"telephone_number": "218-728-4491",
"fax_number": "218-728-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBA",
"first_name": "JAMES",
"middle_name": "F",
"name_prefix": "Mr.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2012-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP0149",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "069248400",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.