Active NPI
Mary J Bayrd, M.A. ED. SPEC
- Clinical Child & Adolescent Psychologist
- Eden Prairie, MN
National Provider Identifier
1750488516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- LP 1463
- Practice address
- 6542 Regency LN
Eden Prairie, MN 55344-7847 - Phone
- (952) 903-9203
- Fax
- (952) 903-9257
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | LP 1463 | MN | Primary |
Addresses
Primary practice location
6542 Regency LN
Eden Prairie, MN 55344-7847
Mailing address
6542 Regency LN
Eden Prairie, MN 55344-7847
Phone (952) 903-9203
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 1463 | MN | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1750488516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6542 REGENCY LN",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447847",
"telephone_number": "952-903-9203",
"fax_number": "952-903-9257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6542 REGENCY LN",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447847",
"telephone_number": "952-903-9203",
"fax_number": "952-903-9257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYRD",
"first_name": "MARY",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "M.A. ED. SPEC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": "LP 1463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.