Individual provider Active NPI

Patrick Thomas Gunter, LP

  • Clinical Psychologist
  • Benson, MN
National Provider Identifier
1114351756
Registry record updated Aug 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP1778 Issued in MN
Practice address
640 Atlantic Ave
Benson, MN 56215-1381
Phone
(320) 843-3454
Fax
(651) 431-7462
NPI assigned
Aug 31, 2013
Last updated
Aug 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP1778 MN Primary

Addresses

Primary practice location

640 Atlantic Ave
Benson, MN 56215-1381

Mailing address

6310 County Road 9 NE
Willmar, MN 56201-9166
Phone (320) 841-1135

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP1778MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Swift County Benson Hospital Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1377907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377907200000",
    "number": "1114351756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 COUNTY ROAD 9 NE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562019166",
            "telephone_number": "320-841-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ATLANTIC AVE",
            "city": "BENSON",
            "state": "MN",
            "postal_code": "562151381",
            "telephone_number": "320-843-3454",
            "fax_number": "651-431-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "credential": "LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-31",
        "last_updated": "2013-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2013; 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.