James Michael Baldus, PH.D., L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0796 Issued in MN

Practice address

5200 Maywood Rd
Mound, MN 55364-1775

Phone

(952) 472-2408

NPI assigned

Oct 9, 2006

Last updated

Oct 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• J M Baldus, Inc

  • Adult Mental Health Clinic/Center
  • Mound, MN
  • NPI 1730520172
  NPD (past) Authorized official

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1700973773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 HIGHVIEW LN",
            "city": "MOUND",
            "state": "MN",
            "postal_code": "553649422",
            "telephone_number": "763-913-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 MAYWOOD RD",
            "city": "MOUND",
            "state": "MN",
            "postal_code": "553641775",
            "telephone_number": "952-472-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDUS",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650552000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Mound, MN
• Providers in Mound, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.