WALTER O BOCKTING (NPI# 1104901172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104901172 |
| Entity Type | Individual |
| Full Name | WALTER O BOCKTING |
| Credential | PHD |
| Practice Address |
1300 S 2nd St Suite 180 Minneapolis MN 55454-1075 |
| Mailing Address |
3989 Central Ave Ne Suite 300 Columbia Heights MN 55421-3900 |
| Practice Telephone | 6126251500 |
| Mailing Telephone | 6126251500 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | LP2505 | MN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP2505 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PREFERREDONE | 1007664 | 01 |
| MN | BLUE CROSS BLUE SHIELD | 602T9BO | 01 |
| MN | UCARE | 102450 | 01 |
| MN | MEDICA - CHOICE | 61-81256 | 01 |
| MN | HEALTHPARTNERS | HP50070 | 01 |
| MN | 048313300 | 05 |
| Street Address |
1300 S 2ND ST SUITE 180 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55454-1075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245349257 | Russell Vincent Luepker | General Acute Care Hospital | 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 | 2006-08-30 |
| 1083065080 | Rachel Becker-warner | Psychologist | 1300 S 2nd St, Minneapolis, MN 55454-1075 | 2016-06-30 |
| 1437583481 | Brenna M Wernersbach | Counselor | 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 | 2013-08-27 |
| 1124452404 | Rebecca Stinson | Psychologist | 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 | 2013-08-22 |
| 1407129786 | Brad Ryan Nederostek | Psychologist | 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 | 2012-02-16 |
| 1073845079 | Katherine G Spencer | Psychologist | 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 | 2010-02-02 |
| 1730265844 | Rosemary Ann Munns | Psychologist | 1300 S 2nd St, Ste 180, Minneapolis, MN 55454-1075 | 2006-10-31 |
| 1598840688 | Sara Jane S Mize | Psychologist | 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 | 2006-10-26 |
| 1487739827 | Michael H Miner | Psychologist | 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 | 2006-10-26 |
| 1902980782 | Joan M Patterson | Psychologist | 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341842 | Bruce Zhang | Student in an Organized Health Care Education/Training Program | 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 | 2020-06-18 |
| 1205456738 | Sara Segner | Student in an Organized Health Care Education/Training Program | Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-24 |
| 1417576844 | Sabena Khan | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 | 2020-04-15 |
| 1811525983 | Kayla Joy Solstad | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-01 |
| 1720647126 | Lauren Harasymiw | Student in an Organized Health Care Education/Training Program | Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-06-10 |
| 1689237448 | Katelyn Marie Adams | Student in an Organized Health Care Education/Training Program | Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-17 |
| 1285197848 | Adrienne Bruder | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-10 |
| 1588142855 | Stewart Graeme Morrison | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 | 2018-07-30 |
| 1831682251 | Sherab Tsheringla | Student in an Organized Health Care Education/Training Program | 2450 Riverside Avenue South, Minneapolis, MN 55454 | 2018-06-11 |
| 1669962148 | Pooja Elizabeth Mishra | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 | 2018-05-10 |
| Find all providers in zip 55454 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
| 1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
| 1831740216 | Seth Gordon Disner | Psychologist | 1 Veterans Dr # B68-2, Minneapolis, MN 55417-2309 | 2019-09-26 |
| 1366090763 | Healing Therapy LLC | Psychologist | 1813 S 6th St Ste 201, Minneapolis, MN 55454-1208 | 2019-08-28 |
| 1891340469 | Karin Fisher | Psychologist | 701 Park Ave # S1.260, Minneapolis, MN 55415-1623 | 2019-08-09 |
| 1053881698 | Lauren Michelle Scholder | Psychologist | 401 Main St Se Apt 7009, Minneapolis, MN 55414 | 2018-11-27 |
| 1902306038 | Ksa Psychological Services, LLC | Psychologist | 5603 Chicago Ave., Minneapolis, MN 55417 | 2018-02-15 |
| 1689030231 | Oliver Ross Psychology and Consulting LLC | Psychologist | 3802 Grand Ave S, Suite A, Minneapolis, MN 55409-1233 | 2016-01-13 |
| 1295100881 | Oliver Ross | Psychologist | 3802a Grand Avenue South, Minneapolis, MN 55409 | 2015-12-08 |
| 1841664190 | Lakes Wellness Center LLC | Psychologist | 3248 Stevens Ave, Minneapolis, MN 55408-3214 | 2015-11-24 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55454 |
Please comment or provide details below to improve the information on WALTER O BOCKTING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.