Ellen S. Teigland, L.P.,P.a.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP2283 Issued in MN

Legal business name

ELLEN S. TEIGLAND, L.P.,P.A.

Practice address

520 NW 1St Ave
Grand Rapids, MN 55744-2619

Phone

(218) 326-7089

Fax

(218) 326-4714

NPI assigned

Sep 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Ellen S Teigland, L.P.,P.A.

Title

Owner

Phone

(218) 326-7089

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1427243005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 794",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557440794",
            "telephone_number": "218-326-7089",
            "fax_number": "218-326-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 NW 1ST AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442619",
            "telephone_number": "218-326-7089",
            "fax_number": "218-326-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN S. TEIGLAND, L.P.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "TEIGLAND",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-326-7089",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.P.,P.A."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MINNESOTA",
            "identifier": "69711TE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.