Individual provider Active NPI

John Richard Mohn, LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1235352253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP1363 Issued in MN
Practice address
1491 Sherburne Ave
Saint Paul, MN 55104-2416
Phone
(651) 254-4374
Fax
(651) 251-2190
NPI assigned
Apr 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP1363 MN Primary

Addresses

Primary practice location

1491 Sherburne Ave
Saint Paul, MN 55104-2416

Mailing address

1491 Sherburne Ave
Saint Paul, MN 55104-2416
Phone (651) 254-4374

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
LP1363MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235352253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 SHERBURNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042416",
            "telephone_number": "651-254-4374",
            "fax_number": "651-251-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 SHERBURNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042416",
            "telephone_number": "651-254-4374",
            "fax_number": "651-251-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHN",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, 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.

Verify at the official NPI Registry.