NPIMap

Organization Active NPI

Groves Academy

  • School Psychologist
  • St Louis Park, MN
National Provider Identifier
1043490824
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
LP1736 Issued in MN
Legal business name
GROVES ACADEMY
Practice address
3200 Highway 100 S
St Louis Park, MN 55416-2175
Phone
(952) 920-6377
Fax
(952) 920-2068
NPI assigned
Nov 8, 2007
Last updated
Nov 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Authorized official

Name
John Alexander, M.ED.
Title
Head
Phone
(952) 915-4257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TS0200X LP1736 MN Primary

Addresses

Primary practice location

3200 Highway 100 S
St Louis Park, MN 55416-2175

Mailing address

3200 Highway 100 S
St Louis Park, MN 55416-2175
Phone (952) 920-6377

National Provider Directory

National Provider Directory

Locations

3200 Highway 100 S
St Louis Park, MN 55416
Phone (952) 915-4287

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1043490824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 HIGHWAY 100 S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162175",
            "telephone_number": "952-920-6377",
            "fax_number": "952-920-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 HIGHWAY 100 S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162175",
            "telephone_number": "952-920-6377",
            "fax_number": "952-920-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVES ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "HEAD",
        "authorized_official_telephone_number": "952-915-4257",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, School",
            "state": "MN",
            "license": "LP1736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.