Individual provider Active NPI

Jennifer Robertson Markworth, MA, LP

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1861728180
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP5147 Issued in MN
Practice address
3633 Pillsbury Ave S
Minneapolis, MN 55409-1218
Phone
(612) 716-4643
NPI assigned
Oct 21, 2009
Last updated
Oct 21, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP5147 MN Primary

Addresses

Primary practice location

3633 Pillsbury Ave S
Minneapolis, MN 55409-1218

Mailing address

3633 Pillsbury Ave S
Minneapolis, MN 55409-1218
Phone (612) 716-4643

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
LP5147MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1861728180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 PILLSBURY AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091218",
            "telephone_number": "612-716-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 PILLSBURY AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091218",
            "telephone_number": "612-716-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKWORTH",
        "first_name": "JENNIFER",
        "middle_name": "ROBERTSON",
        "name_prefix": "Ms.",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.