Ross E Gubrud, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5984 Issued in MN

Practice address

1821 University Ave W Ste 461-9
Saint Paul, MN 55104-2801

Phone

(612) 421-3178

Fax

(612) 421-3183

NPI assigned

Mar 29, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1285166355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 XENIUM LN N APT 123",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554412222",
            "telephone_number": "612-421-3178",
            "fax_number": "612-421-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 461-9",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042801",
            "telephone_number": "612-421-3178",
            "fax_number": "612-421-3183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Xenium Ln N Apt 123",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554412222",
            "country_code": "US",
            "telephone_number": "126-421-3187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUBRUD",
        "first_name": "ROSS",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Gryzan, MD
• GS Transportation LLC
• Yu Guan
• Guardian Autism Center LLC
• Guardian Health Services
• Sydney Gudvangen, OTR/L
• Sammy Louis Gueringer II, DMD
• Laura J Gueron, PT
• Hildalicia Guerra, M.D.
• Marco A Guerrero, MD

• Clinical Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.