Active NPI
Wayne Anthony Arnzen, L.P
- Clinical Psychologist
- Grand Marais, MN
National Provider Identifier
1780738385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP 1185
- Practice address
- 342 Pike Lake Rd
Grand Marais, MN 55604-2230 - Phone
- (218) 387-1098
- Fax
- (218) 387-1098
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- 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 Psychologist | 103TC0700X | LP 1185 | MN | Primary |
Addresses
Primary practice location
342 Pike Lake Rd
Grand Marais, MN 55604-2230
Mailing address
342 Pike Lake Rd
Grand Marais, MN 55604-2230
Phone (218) 387-1098
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111499 | Other | MN | U CARE |
| 53G35AR | Other | MN | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 1185 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780738385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "342 PIKE LAKE RD",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556042230",
"telephone_number": "218-387-1098",
"fax_number": "218-387-1098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "342 PIKE LAKE RD",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556042230",
"telephone_number": "218-387-1098",
"fax_number": "218-387-1098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARNZEN",
"first_name": "WAYNE",
"middle_name": "ANTHONY",
"credential": "L.P",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP 1185",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "111499",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "53G35AR",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Marais, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.