Active NPI
Troy W Ertelt
- Psychologist
- Grand Forks, ND
National Provider Identifier
1720344898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 725 Hamline St
Grand Forks, ND 58203-2819 - Phone
- (701) 780-6858
- Fax
- (701) 780-1973
- NPI assigned
- Apr 3, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
725 Hamline St
Grand Forks, ND 58203-2819
Mailing address
725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6858
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assessment and Therapy Associates of Grand Forks, PLLC | 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 and National Provider Directory roles.
-
- Clinical Psychologist
- Grand Forks, ND
- NPI 1437181591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333411200000",
"number": "1720344898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 HAMLINE ST",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582032819",
"telephone_number": "701-780-6858",
"fax_number": "701-780-1973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 HAMLINE ST",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582032819",
"telephone_number": "701-780-6858",
"fax_number": "701-780-1973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERTELT",
"first_name": "TROY",
"middle_name": "W",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-03",
"last_updated": "2012-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.