Individual provider Active NPI

Jeffrey Pounds, LP

  • Psychologist
  • Pine City, MN
National Provider Identifier
1275552267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP 4626 Issued in MN
Practice address
220 Railroad St SE
Pine City, MN 55063-1540
Phone
(320) 629-7600
Fax
(320) 629-7900
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

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 LP 4626 MN Primary

Addresses

Primary practice location

220 Railroad St SE
Pine City, MN 55063-1540

Mailing address

220 Railroad St SE
Pine City, MN 55063-1540
Phone (320) 629-7600

Other identifiers 2

IdentifierTypeStateIssuer
03N75POOtherMNBCBS
HP 60172OtherMNHEALTH PARTNERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160114000083 MN Practitioner - Clinical Psychologist 4284936865 Reassigns benefits to 2 organizations
I20240307001676 MN Practitioner - Mental Health Counselor 4284936865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Behavioral Health and Wellness Center, PLLCGroup PAC ID 3678625035, 17 clinicians

Practice addresses (Care Compare)

8640 Eagle Creek Cir
Savage, MN 55378-4400
Phone (952) 746-7664

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP 4626MNMDPsychologist
4626MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Mar 20, 2024 Accepting new patients
Healtheast Medical Research Institute Psychologist CurrentSince Mar 7, 2023 Accepting new patients
River Valley Behavioral Health & Wellness Center, PLLC CurrentSince Jan 1, 2024 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Mar 20, 2024 Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

8640 Eagle Creek Cir
Savage, MN 55378
Phone (952) 746-7664

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275552267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RAILROAD ST SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631540",
            "telephone_number": "320-629-7600",
            "fax_number": "320-629-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RAILROAD ST SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631540",
            "telephone_number": "320-629-7600",
            "fax_number": "320-629-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUNDS",
        "first_name": "JEFFREY",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 4626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03N75PO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP 60172",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine City, MN

Sources for this page

Verify at the official NPI Registry.