Individual provider Active NPI

Sandra Ferrell, MA, LP

  • Psychologist
  • Austin, MN
National Provider Identifier
1750782389
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP0498 Issued in MN
Practice address
203 10TH Ave NW
Austin, MN 55912-2909
Phone
(507) 437-9085
Fax
(507) 437-2393
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP0498 MN Primary

Addresses

Primary practice location

203 10TH Ave NW
Austin, MN 55912-2909

Mailing address

203 10TH Ave NW
Austin, MN 55912-2909
Phone (507) 437-9085

Other identifiers 2

IdentifierTypeStateIssuer
385734401MedicaidMN
385734400MedicaidMN

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

LicenseStateTypeSpecialty
LP0498MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Case Management, Inc. Past Accepting new patients
Quality Case Management, in.C Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1750782389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 10TH AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122909",
            "telephone_number": "507-437-9085",
            "fax_number": "507-437-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 10TH AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122909",
            "telephone_number": "507-437-9085",
            "fax_number": "507-437-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRELL",
        "first_name": "SANDRA",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385734401",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385734400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.