Individual provider Active NPI

Ronald L Malzer, PHD

  • Psychologist
  • La Crosse, WI
National Provider Identifier
1366424590
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1810 Issued in WI
Practice address
212 11TH St S
La Crosse, WI 54601-4116
Phone
(608) 791-9555
Fax
(608) 791-9432
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1810 WI Primary

Addresses

Primary practice location

212 11TH St S
La Crosse, WI 54601-4116

Mailing address

212 11TH St S
La Crosse, WI 54601-4116
Phone (608) 791-9555

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1366424590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 11TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014116",
            "telephone_number": "608-791-9555",
            "fax_number": "608-791-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 11TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014116",
            "telephone_number": "608-791-9555",
            "fax_number": "608-791-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALZER",
        "first_name": "RONALD",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.