Individual provider Active NPI

William Roger Spitzmueller, PSY.D.

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1417022674
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP0657 Issued in MN
Practice address
1600 University Ave W
Suite 303
Saint Paul, MN 55104-3898
Phone
(651) 644-1813
Fax
(651) 644-1870
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP0657 MN Primary

Addresses

Primary practice location

1600 University Ave W
Suite 303
Saint Paul, MN 55104-3898

Mailing address

1600 University Ave W
Suite 303
Saint Paul, MN 55104-3898
Phone (651) 644-1813

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

State licenses

LicenseStateTypeSpecialty
LP0657MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maureen Gaffey, Psy. D., LLC. Clinical 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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417022674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W",
            "address_2": "SUITE 303",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-644-1813",
            "fax_number": "651-644-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W",
            "address_2": "SUITE 303",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-644-1813",
            "fax_number": "651-644-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITZMUELLER",
        "first_name": "WILLIAM",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP0657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.