Ross Fulton Barr, PSY.D, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6040 Issued in MN

Practice address

12301 Whitewater Dr Ste 101
Minnetonka, MN 55343-4157

Phone

(952) 999-6097

Fax

(952) 426-0508

NPI assigned

Jul 15, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 5, 2022 through Aug 5, 2026

Medicare enrollment (NPD)

Enrolled

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.

• Kestrel Behavioral Health Consulting, LLC

  • Clinical Psychologist
  • Fort Collins, CO
  • NPI 1275240616
  NPD Authorized official
• Shift Limited Liability Company

  • Mental Health Counselor
  • Minnetonka, MN
  • NPI 1437749702
  NPD (past)

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1851775308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 MADISON ST",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032518",
            "telephone_number": "612-719-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WHITEWATER DR STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434157",
            "telephone_number": "952-999-6097",
            "fax_number": "952-426-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARR",
        "first_name": "ROSS",
        "middle_name": "FULTON",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-15",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP6040",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851775308",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon M Bankemper
• Barbara a Johnson MD PA
• Jenna Rae Barbeln, OTR/L
• Kathryn Barker, NP
• Farhiya Barqadle
• Hannah Maria Barrett, MA LPCC
• Holly Kathryn Barrett, ARNP
• Katherine Ann Barrett, OTD
• Sarah Barrett, LICSW
• Kari Barth, M.A, L.P

• Clinical Psychologist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.