Paul R Endres, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0346LP Issued in MN

Practice address

4505 White Bear Pkwy
Suite 1800
White Bear Lake, MN 55110

Phone

(651) 426-8191

Fax

(651) 426-6766

NPI assigned

Oct 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Human Development of White Bear Lake, Inc.

  • Psychologist
  • White Bear Lake, MN
  • NPI 1639250111
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437231933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 MIDLAND GROVE RD",
            "address_2": "#305",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-633-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY",
            "address_2": "SUITE 1800",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "651-426-8191",
            "fax_number": "651-426-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRES",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "0346LP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Eichmiller, L.AC.
• Jeffrey D Elbers, MD
• Paige Ellefson
• Hannah Ellingson
• Brooke Leigh Elvehjem, PA-C
• Jessica Ann Engman, OTR/L
• Dorothy Carmelite Enockson Sr., LICSW
• Enrichmentgroup (Haven for Hope MN)
• Nora Marie Erdrich
• Grant Erickson, D.C.

• Psychologist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Psychologist in Minnesota

• 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.