Active NPI
Scott Robert Emmons, LP
- Psychologist
- Pine City, MN
National Provider Identifier
1992945794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP5038
- Practice address
- 900 Golf Ave SW
Pine City, MN 55063-5015 - Phone
- (320) 629-7600
- Fax
- (320) 629-7900
- NPI assigned
- Mar 6, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP5038 | MN | Primary |
Addresses
Primary practice location
900 Golf Ave SW
Pine City, MN 55063-5015
Mailing address
220 Railroad St SE
Pine City, MN 55063-1540
Phone (320) 629-7600
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 |
|---|---|---|---|
| LP5038 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Services Agency Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Pine City, MN
- NPI 1497741607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236297600000",
"number": "1992945794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 RAILROAD ST SE",
"city": "PINE CITY",
"state": "MN",
"postal_code": "550631540",
"telephone_number": "320-629-7600",
"fax_number": "320-629-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 GOLF AVE SW",
"city": "PINE CITY",
"state": "MN",
"postal_code": "550635015",
"telephone_number": "320-629-7600",
"fax_number": "320-629-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMMONS",
"first_name": "SCOTT",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-06",
"last_updated": "2009-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine City, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.