Individual provider Active NPI

Molly Ruggles, PSY.D., L.P.

  • Clinical Psychologist
  • Apple Valley, MN
National Provider Identifier
1629312830
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP5535 Issued in MN
Practice address
14665 Galaxie Ave
Suite 140
Apple Valley, MN 55124-4507
Phone
(952) 431-6033
NPI assigned
Nov 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP5535 MN Primary

Addresses

Primary practice location

14665 Galaxie Ave
Suite 140
Apple Valley, MN 55124-4507

Mailing address

1129 Grand Ave
Saint Paul, MN 55105-2629
Phone (651) 641-0177

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130423000114 MN Practitioner - Clinical Psychologist 9335385160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FamilymeansGroup PAC ID 9830085182, 12 clinicians

Practice addresses (Care Compare)

1129 Grand Ave
Saint Paul, MN 55105-2629
Phone (651) 439-4840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP5535MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Familymeans CurrentSince Oct 24, 2013 Accepting new patients
Ruggles Psychotherapy & Consulting LLC Current Accepting new patients
Oak Ridge Center PLLC PastSince Feb 1, 2004 Accepting new patients
Iris Mental Health, LLC PastSince Jan 1, 2024 Accepting new patients

Locations

1129 Grand Ave
Saint Paul, MN 55105
Phone (651) 268-3252

1875 Northwestern Ave S
Stillwater, MN 55082
Phone (651) 439-4840

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1629312830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "651-641-0177",
            "fax_number": "651-641-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14665 GALAXIE AVE",
            "address_2": "SUITE 140",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244507",
            "telephone_number": "952-431-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGLES",
        "first_name": "MOLLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-12",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.