Active NPI
Evert Ray Boyd, L.P. M.S.E.
- School Psychologist
- St Louis Park, MN
National Provider Identifier
1316469760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- LP1736
- Practice address
- 3200 Highway 100 S.
Groves Academy
St Louis Park, MN 55416 - Phone
- (952) 920-6377
- Fax
- (952) 920-2068
- NPI assigned
- Jul 7, 2017
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | LP1736 | MN | Primary |
Addresses
Primary practice location
3200 Highway 100 S.
Groves Academy
St Louis Park, MN 55416
Mailing address
3200 Highway 100 S.
Groves Academy
St. Louis Park, MN 55416
Phone (952) 920-6377
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
| License | State | Type | Specialty |
|---|---|---|---|
| LP1736 | MN | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Groves Academy | School | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- School Psychologist
- St Louis Park, MN
- NPI 1043490824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499385600000",
"number": "1316469760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 HIGHWAY 100 S.",
"address_2": "GROVES ACADEMY",
"city": "ST. LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "952-920-6377",
"fax_number": "952-920-2068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 HIGHWAY 100 S.",
"address_2": "GROVES ACADEMY",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "952-920-6377",
"fax_number": "952-920-2068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "EVERT",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "L.P. M.S.E.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-07",
"last_updated": "2017-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MN",
"license": "LP1736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.