Active NPI
Gerald Duane Gregersen, PHD, LP
- Psychologist
- Faribault, MN
National Provider Identifier
1124080098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP0353
- Practice address
- 100 State Ave
Faribault, MN 55021-6337 - Phone
- (507) 334-3921
- Fax
- (507) 332-5297
- NPI assigned
- Apr 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP0353 | MN | Primary |
Addresses
Primary practice location
100 State Ave
Faribault, MN 55021-6337
Mailing address
PO Box 43
Mr 10809
Minneapolis, MN 55440-0043
Phone (612) 262-4813
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP0353 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124080098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43",
"address_2": "MR 10809",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554400043",
"telephone_number": "612-262-4813",
"fax_number": "612-262-4194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 STATE AVE",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550216337",
"telephone_number": "507-334-3921",
"fax_number": "507-332-5297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGERSEN",
"first_name": "GERALD",
"middle_name": "DUANE",
"credential": "PHD, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP0353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Faribault, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.