Organization Active NPI

John N. O'Neil, PH.D., L.P., LLC

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1306921275
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4307 Issued in MN
Legal business name
JOHN N. O'NEIL, PH.D., L.P., LLC
Practice address
825 Nicollet Mall
1735 Medical Arts Building
Minneapolis, MN 55402-2704
Phone
(612) 455-6167
Fax
(612) 333-6740
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Dr. John Nolen O'Neil, PH.D.
Title
Licensed Psychologist
Phone
(612) 455-6167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X LP4307 MN Primary

Addresses

Primary practice location

825 Nicollet Mall
1735 Medical Arts Building
Minneapolis, MN 55402-2704

Mailing address

825 Nicollet Mall
1735 Medical Arts Building
Minneapolis, MN 55402-2704
Phone (612) 455-6167

Other identifiers 5

IdentifierTypeStateIssuer
169041OtherMNUCARE
6169449OtherMEDICA
013764200MedicaidMN
49F69ONOtherMNBLUE CROSS BLUE SHIELD
HP40630OtherMNHEALTH PARTNERS

National Provider Directory

National Provider Directory

Locations

825 Nicollet Mall
Ste 1735
Minneapolis, MN 55402
Phone (612) 333-3825

825 S 8th St
Ste 604
Minneapolis, MN 55404
Phone (612) 333-3825

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1306921275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "1735 MEDICAL ARTS BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022704",
            "telephone_number": "612-455-6167",
            "fax_number": "612-333-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "1735 MEDICAL ARTS BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022704",
            "telephone_number": "612-455-6167",
            "fax_number": "612-333-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN N. O'NEIL, PH.D., L.P., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "O'NEIL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NOLEN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-455-6167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "169041",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6169449",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013764200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49F69ON",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP40630",
            "state": "MN"
        }
    ],
    "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 May 6, 2008; 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.