Active NPI
Speare & Sampson PA
- Clinical Psychologist
- Virginia, MN
National Provider Identifier
1366659005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP1373
- Legal business name
- SPEARE & SAMPSON PA
- Practice address
- 225 1St St N
Suite 3100
Virginia, MN 55792 - Phone
- (218) 741-3740
- NPI assigned
- May 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jonathan Speare, PHD LIC PSYCHOLOGIST
- Title
- Ceo
- Phone
- (218) 741-3740
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP1373 | MN | Primary |
| Clinical Psychologist | 103TC0700X | LP0655 | MN |
Addresses
Primary practice location
225 1St St N
Suite 3100
Virginia, MN 55792
Mailing address
225 1St St N
Suite 3100
Virginia, MN 55792
Phone (218) 741-3740
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110499 | Other | MN | UCARE |
| 8L596SP | Other | MN | BCBS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- Virginia, MN
- NPI 1962537282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1366659005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 1ST ST N",
"address_2": "SUITE 3100",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "55792",
"telephone_number": "218-741-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 1ST ST N",
"address_2": "SUITE 3100",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "55792",
"telephone_number": "218-741-3740"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPEARE & SAMPSON PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-16",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SPEARE",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "218-741-3740",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD LIC PSYCHOLOGIST"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1373",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP0655",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "110499",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8L596SP",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.