Geoffrey Clyde Ammerman, MS.ED., LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP1904 Issued in MN

Practice address

927 Trettel LN
Cloquet, MN 55720-1345

Phone

(218) 879-1227

NPI assigned

Jul 7, 2006

Last updated

Apr 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1356373328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMERMAN",
        "first_name": "GEOFFREY",
        "middle_name": "CLYDE",
        "credential": "MS.ED., LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870748100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 705 Horizon Circle Opco LLC
• Marie Gibson Adebisi, MARIE
• Jeffery Agaton Howes, MSW, LICSW, LADC
• Valerie Aird, PHARMD
• Megan Marie Alama, LICSW
• Abigail Nancy Anderson, PA-C
• Ben Earl Anderson, PHARMD
• David Scott Anderson, MD
• Haley Anderson, DDS
• Jane M Anderson, PSYCHOLOGIST

• Psychologist in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.