Individual provider Active NPI

Rosemary Ann Munns, PSYD

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1730265844
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4196 Issued in MN
Practice address
1300 S 2ND St
Ste 180
Minneapolis, MN 55454-1075
Phone
(612) 625-1500
NPI assigned
Oct 31, 2006
Last updated
Jul 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP4196 MN
Clinical Psychologist 103TC0700X LP4196 MN Primary

Addresses

Primary practice location

1300 S 2ND St
Ste 180
Minneapolis, MN 55454-1075

Mailing address

3989 Central Ave NE
Suite 300
Columbia Heights, MN 55421-3900
Phone (612) 625-1500

Other identifiers 5

IdentifierTypeStateIssuer
111016100MedicaidMN
109837OtherMNUCARE
61-91215OtherMNMEDICA CHOICE
1023241OtherMNPREFERRED ONE
HP32430OtherMNHEALTH PARTNERS

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

State licenses

LicenseStateTypeSpecialty
LP4196MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge Medical Supply, 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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1730265844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3989 CENTRAL AVE NE",
            "address_2": "SUITE 300",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554213900",
            "telephone_number": "612-625-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S 2ND ST",
            "address_2": "STE 180",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541075",
            "telephone_number": "612-625-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNNS",
        "first_name": "ROSEMARY",
        "middle_name": "ANN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4196",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111016100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "109837",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "61-91215",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1023241",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP32430",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.