Active NPI
Allyn Krumholz, LP
- Intellectual & Developmental Disabilities Psychologist
- Winona, MN
National Provider Identifier
1376641605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- LP #1603
- Practice address
- 51 E 4TH St
Suite 19
Winona, MN 55987-3507 - Phone
- (507) 458-6538
- Fax
- (507) 454-4420
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP #1603 | MN | |
| Counseling Psychologist | 103TC1900X | LP #1603 | MN | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | LP #1603 | MN | Primary |
Addresses
Primary practice location
51 E 4TH St
Suite 19
Winona, MN 55987-3507
Mailing address
51 E 4TH St
Suite 19
Winona, MN 55987-3507
Phone (507) 458-6538
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106962 | Other | MN | UCARE MINNESOTA # |
| 3H089KR | Other | MN | BCBS INDIVIDUAL PROVIDER# |
| 3H088KR | Other | MN | BCBS GROUP # |
| 6270799 | Other | MN | MEDICA/UBH PROVIDER# |
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 |
|---|---|---|---|
| LP #1603 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1376641605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 E 4TH ST",
"address_2": "SUITE 19",
"city": "WINONA",
"state": "MN",
"postal_code": "559873507",
"telephone_number": "507-458-6538",
"fax_number": "507-454-4420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 E 4TH ST",
"address_2": "SUITE 19",
"city": "WINONA",
"state": "MN",
"postal_code": "559873507",
"telephone_number": "507-458-6538",
"fax_number": "507-454-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUMHOLZ",
"first_name": "ALLYN",
"name_prefix": "Mr.",
"credential": "LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP #1603",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP #1603",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "MN",
"license": "LP #1603",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MINNESOTA #",
"identifier": "106962",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS INDIVIDUAL PROVIDER#",
"identifier": "3H089KR",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP #",
"identifier": "3H088KR",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA/UBH PROVIDER#",
"identifier": "6270799",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.