Active NPI
Jon E Walser-Kuntz, LP
- Psychologist
- Northfield, MN
National Provider Identifier
1508803578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP3899
- Practice address
- 501 Nevada St
Northfield, MN 55057-2302 - Phone
- (507) 301-8625
- Fax
- (507) 664-0766
- NPI assigned
- May 31, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP3899 | MN | Primary |
Addresses
Primary practice location
501 Nevada St
Northfield, MN 55057-2302
Mailing address
501 Nevada St
Northfield, MN 55057-2302
Phone (507) 301-8625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240621003707 | MN | Practitioner - Mental Health Counselor | 1557804226 | Practice locations: Faribault, MN, MN; Northfield, MN |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1994
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
118 Central Ave N
Faribault, MN, MN 55021-5211
Phone (507) 301-8625
501 Nevada St
Northfield, MN 55057-2302
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3899 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508803578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 NEVADA ST",
"city": "NORTHFIELD",
"state": "MN",
"postal_code": "550572302",
"telephone_number": "507-301-8625",
"fax_number": "507-664-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 NEVADA ST",
"city": "NORTHFIELD",
"state": "MN",
"postal_code": "550572302",
"telephone_number": "507-301-8625",
"fax_number": "507-664-0766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSER-KUNTZ",
"first_name": "JON",
"middle_name": "E",
"credential": "LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP3899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.