Michael Backman, MS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3252 Issued in MN

Practice address

400 East First Street
Morris, MN 56267-0660

Phone

(320) 589-1313

Fax

(320) 589-3533

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043312481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "address_2": "400 EAST FIRST STREET",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562670660",
            "telephone_number": "320-589-1313",
            "fax_number": "320-589-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST FIRST STREET",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562670660",
            "telephone_number": "320-589-1313",
            "fax_number": "320-589-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKMAN",
        "first_name": "MICHAEL",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Morris, MN
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• 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.

Verify at the official NPI Registry.