Jeanine E. Kotschwar, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

177 Issued in ND

Practice address

2100 S Columbia Rd
Suite 202
Grand Forks, ND 58201-5895

Phone

(701) 772-1588

Fax

(701) 746-6077

NPI assigned

Jul 14, 2006

Last updated

Sep 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Jeanine E Entingh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Practice Place, PLLC

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1184283541
  NPD

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1083630974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S COLUMBIA RD",
            "address_2": "SUITE 202",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015895",
            "telephone_number": "701-772-1588",
            "fax_number": "701-746-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S COLUMBIA RD",
            "address_2": "SUITE 202",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015895",
            "telephone_number": "701-772-1588",
            "fax_number": "701-746-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSCHWAR",
        "first_name": "JEANINE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUE CROSS",
            "identifier": "197M7K0",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366850900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BLUE CROSS",
            "identifier": "KOT22727",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16917",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANINE",
            "last_name": "ENTINGH",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn Korsmo, DDS
• Stephen A Korte, MD
• Kayla Korynta, OT
• Brianna Rae Kosel, MOTR/L
• Jessica Marie Kotrba, FNP-C
• Mara Kotzbacher, LBSW
• Jessica Kovsky, OTR/L
• Kaila Ann Kowalski, PTA
• Lynn Marie Kowalski, COTA/L
• Olivia Alexandra Kozel, MD

• Clinical Psychologist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.