Robert W Ogren, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6457 Issued in MN

Practice address

18322 Minnetonka Blvd Ste C
Wayzata, MN 55391-3258

Phone

(651) 308-2290

NPI assigned

Nov 1, 2019

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)

Enrolled

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1437793437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 VERNON AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163139",
            "telephone_number": "858-220-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18322 MINNETONKA BLVD STE C",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553913258",
            "telephone_number": "651-308-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGREN",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.