James Vincent Shreffler, PSY. D., L. P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6416 Issued in MN

Practice address

324 W Superior St Ste 620
Duluth, MN 55802-1723

Phone

(218) 722-2005

NPI assigned

Jun 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Duluth Psychological Clinic Inc

  • Clinical Psychologist
  • Duluth, MN
  • NPI 1730243809
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575763200000",
    "number": "1770143331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5206 HOWARD GNESEN RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558039481",
            "telephone_number": "218-206-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 620",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021723",
            "telephone_number": "218-722-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREFFLER",
        "first_name": "JAMES",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "PSY. D., L. P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Shogren, PSYD
• Phalecia Ekko Shogren
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shoptikal LLC
• Thomas Francis Shuey
• Jonathan Foster Shultz, M.D.
• Sara Marie Shuster, PHARMD
• Madeline Sicora, AUD
• Krystal Siegle, R.N.

• Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2019; 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.