Active NPI
Mary K. Schmidt, PH.D.
- Clinical Psychologist
- Fergus Falls, MN
National Provider Identifier
1598797185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP0850
- Practice address
- 126 E Alcott Ave
Fergus Falls, MN 56537-2903 - Phone
- (218) 736-6987
- Fax
- (218) 736-6980
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP0850 | MN | Primary |
Addresses
Primary practice location
126 E Alcott Ave
Fergus Falls, MN 56537-2903
Mailing address
321 W Vernon Ave
Fergus Falls, MN 56537-2625
Phone (218) 736-6987
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010531 | Other | MN | PREFERREDONE |
| 116407 | Other | MN | UCARE MINNESOTA |
| HP23071 | Other | MN | HEALTHPARTNERS |
| 61-20354 | Other | MN | UNITED BEHAVIORAL HEALTH |
| 914750100 | Medicaid | MN | |
| 61813SC | Other | FM | BLUE SHIELD OF MINNESOTA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1446 | MN | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1598797185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 W VERNON AVE",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372625",
"telephone_number": "218-736-6987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 E ALCOTT AVE",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372903",
"telephone_number": "218-736-6987",
"fax_number": "218-736-6980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHMIDT",
"first_name": "MARY",
"middle_name": "K.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP0850",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "1010531",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MINNESOTA",
"identifier": "116407",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP23071",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "61-20354",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "914750100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF MINNESOTA",
"identifier": "61813SC",
"state": "FM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.