Active NPI
Kathryn Claire Pearson
- Psychologist
- Minneapolis, MN
National Provider Identifier
1235168840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP1113
- Practice address
- 2450 Riverside Ave
F196
Minneapolis, MN 55454-1512 - Phone
- (612) 672-2130
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- 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 | LP1113 | MN | Primary |
Addresses
Primary practice location
2450 Riverside Ave
F196
Minneapolis, MN 55454-1512
Mailing address
423 337TH Ave NE
Cambridge, MN 55008-9102
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
| License | State | Type | Specialty |
|---|---|---|---|
| LP1113 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235168840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 337TH AVE NE",
"city": "CAMBRIDGE",
"state": "MN",
"postal_code": "550089102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"address_2": "F196",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541512",
"telephone_number": "612-672-2130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "KATHRYN",
"middle_name": "CLAIRE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP1113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.