NPIMap

Organization Active NPI

Calm-Clinic for Attention, Learning, and Memor

Doing business as Clinic for Attention, Learning, and Memory, PA

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1053614131
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP1794 Issued in MN
Legal business name
CALM-CLINIC FOR ATTENTION, LEARNING, AND MEMOR
Doing business as
Clinic for Attention, Learning, and Memory, PA
Practice address
1409 Willow St
Suite 600
Minneapolis, MN 55403-2269
Phone
(612) 872-9072
Fax
(612) 872-8605
NPI assigned
Dec 13, 2010
Last updated
Dec 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Authorized official

Name
Dr. Gary Gene Johnson, PHDNPI 1245452291
Title
Owner & President
Phone
(612) 419-3266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP1794 MN Primary

Addresses

Primary practice location

1409 Willow St
Suite 600
Minneapolis, MN 55403-2269

Mailing address

1409 Willow St
#600
Minneapolis, MN 55403
Phone (612) 872-2343

Other names 1

  • CLINIC FOR ATTENTION, LEARNING, AND MEMORY, PA Doing business as

National Provider Directory

National Provider Directory

Locations

1409 Willow St
Ste 600
Minneapolis, MN 55403
Phone (612) 872-2343

Practitioners & affiliated clinicians

Practitioners 6

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": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1053614131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST",
            "address_2": "#600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55403",
            "telephone_number": "612-872-2343",
            "fax_number": "612-872-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST",
            "address_2": "SUITE 600",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032269",
            "telephone_number": "612-872-9072",
            "fax_number": "612-872-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM-CLINIC FOR ATTENTION, LEARNING, AND MEMOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "OWNER & PRESIDENT",
        "authorized_official_telephone_number": "612-419-3266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINIC FOR ATTENTION, LEARNING, AND MEMORY, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.