Active NPI
Matthew Gene James, PH.D.
- Clinical Psychologist
- St Louis Park, MN
National Provider Identifier
1073880027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5427
- Practice address
- 3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527 - Phone
- (952) 993-3400
- NPI assigned
- Nov 18, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 5427 | MN | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 5427 | MN | |
| Clinical Psychologist | 103TC0700X | 5427 | MN | Primary |
Addresses
Primary practice location
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Mailing address
8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Other practice location 1
1095 Highway 15 S
Hutchinson, MN 55350-5000
Phone (320) 484-4610
Other practice location 2
1095 Highway 15 S
Hutchinson, MN 55350-5000
Phone (320) 484-4610
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5427 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1073880027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 PARK NICOLLET BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162527",
"telephone_number": "952-993-3400"
}
],
"practiceLocations": [
{
"address_1": "1095 Highway 15 S",
"address_purpose": "LOCATION",
"city": "Hutchinson",
"state": "MN",
"postal_code": "553505000",
"country_code": "US",
"telephone_number": "320-484-4610",
"fax_number": "320-234-4652",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1095 Highway 15 S",
"address_purpose": "LOCATION",
"city": "Hutchinson",
"state": "MN",
"postal_code": "553505000",
"country_code": "US",
"telephone_number": "320-484-4610",
"fax_number": "320-234-4652",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAMES",
"first_name": "MATTHEW",
"middle_name": "GENE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MN",
"license": "5427",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": "5427",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "5427",
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.