Individual provider Active NPI

Carol Ann Gronseth, M.S.,L.P.

  • Psychologist
  • Rochester, MN
National Provider Identifier
1629131164
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP 3678 Issued in MN
Practice address
315 Elton Hills Dr NW
Rochester, MN 55901-2477
Phone
(507) 287-7105
Fax
(507) 529-4570
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP 3678 MN Primary

Addresses

Primary practice location

315 Elton Hills Dr NW
Rochester, MN 55901-2477

Mailing address

5630 County Road 103 NW
Byron, MN 55920-4105

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LP 3678MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629131164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 COUNTY ROAD 103 NW",
            "city": "BYRON",
            "state": "MN",
            "postal_code": "559204105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ELTON HILLS DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012477",
            "telephone_number": "507-287-7105",
            "fax_number": "507-529-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONSETH",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "M.S.,L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 3678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.