Individual provider Active NPI

Dana Fox, PH.D.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1033253570
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP2848 Issued in MN
Practice address
821 Raymond Ave Ste 220
Saint Paul, MN 55114-1525
Phone
(612) 605-6575
NPI assigned
Feb 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP2848 MN Primary

Addresses

Primary practice location

821 Raymond Ave Ste 220
Saint Paul, MN 55114-1525

Mailing address

821 Raymond Ave Ste 220
Saint Paul, MN 55114-1525
Phone (612) 605-6575

Other practice location 1

2402 Hennepin Ave
Minneapolis, MN 55405-2686
Phone (612) 605-6575

Other identifiers 1

IdentifierTypeStateIssuer
813750100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110322000673 MN Practitioner - Clinical Psychologist 8628251097 Practice locations: Minneapolis, MN; Saint Paul, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

821 Raymond Ave
Suite 200
Saint Paul, MN 55114-1509
Phone (612) 605-6575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP2848MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbeing Collaborative, LTD. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1033253570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE STE 220",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "612-605-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE STE 220",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "612-605-6575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2402 Hennepin Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554052686",
            "country_code": "US",
            "telephone_number": "612-605-6575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "DANA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "813750100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.