Active NPI
Charles Fields, MA, LP
- Clinical Psychologist
- Baxter, MN
National Provider Identifier
1316186877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0231
- Practice address
- 13021 Evergreen Dr
Baxter, MN 56425-7439 - Phone
- (218) 829-9307
- NPI assigned
- Feb 6, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0231 | MN | Primary |
Addresses
Primary practice location
13021 Evergreen Dr
Baxter, MN 56425-7439
Mailing address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233878400000",
"number": "1316186877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 SILVER LAKE RD NW",
"address_2": "SUITE 110",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551121786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13021 EVERGREEN DR",
"city": "BAXTER",
"state": "MN",
"postal_code": "564257439",
"telephone_number": "218-829-9307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIELDS",
"first_name": "CHARLES",
"credential": "MA, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-06",
"last_updated": "2009-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "0231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.