Anna Jelbert Bogestad Schupp, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5293 Issued in MN

Practice address

12301 Whitewater Dr
Ste 101
Minnetonka, MN 55343-9447

Phone

(952) 999-6097

Fax

(952) 426-0508

NPI assigned

Dec 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sonder Behavioral Health & Wellness, Inc.

  • Clinical Psychologist
  • Minnetonka, MN
  • NPI 1780031732
  Medicare reassignment NPD
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD
• Psychotherapeutic Resources LLP

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1619059755
  NPD (past)

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1548444292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 WHITEWATER DR",
            "address_2": "STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439447",
            "telephone_number": "952-999-6097",
            "fax_number": "952-426-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WHITEWATER DR",
            "address_2": "STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439447",
            "telephone_number": "952-999-6097",
            "fax_number": "952-426-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "ANNA",
        "middle_name": "JELBERT BOGESTAD",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548444292",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy B Schulting, PHD, M.ED., LP
• Jane M Schultz, CRNA
• Joshua Schulz
• Schumacher Tranportation
• Anna Schumack
• Jennifer Lani Schwab, MD
• Carl R Schwabe, APNP
• James Ross Schwartz, DDS
• Lauren Schwartz
• Renee Trombley Schwartz, M.S, P.A.-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.