Individual provider Active NPI

Gerald E. Ziesemer, PH.D.

  • Forensic Psychologist
  • Fergus Falls, MN
National Provider Identifier
1720021751
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
LP0697 Issued in MN
Practice address
126 E Alcott Ave
Fergus Falls, MN 56537-2903
Phone
(218) 736-6987
Fax
(218) 736-0734
NPI assigned
Jun 14, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP0697 MN
Forensic Psychologist 103TF0200X LP0697 MN Primary

Addresses

Primary practice location

126 E Alcott Ave
Fergus Falls, MN 56537-2903

Mailing address

934 W Linden St
Fergus Falls, MN 56537-1048

Other identifiers 4

IdentifierTypeStateIssuer
59198ZIOtherMNBLUE SHIELD OF MINNESOTA
HP48651OtherMNHEALTHPARTNERS
104276OtherMNUCARE MINNESOTA
1042327OtherMNPREFERREDONE

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

LicenseStateTypeSpecialty
LP0697MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Mental Health Center, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720021751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 W LINDEN ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371048"
        },
        {
            "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": "218-736-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIESEMER",
        "first_name": "GERALD",
        "middle_name": "E.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP0697",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MN",
            "license": "LP0697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MINNESOTA",
            "identifier": "59198ZI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP48651",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "104276",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1042327",
            "state": "MN"
        }
    ],
    "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 Jul 13, 2026; 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.