Gwyn Mahony Hadeed, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2022038658 Issued in MO

Practice address

401 Holly Hills Ave
Saint Louis, MO 63111-2410

Phone

(314) 353-5190

Fax

(314) 353-7631

NPI assigned

Apr 27, 2014

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Gwyn Mahony Professional name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
• Salem Hospital Hospital, Salem, OR, CCN 380051
• Salem Health West Valley Hospital, Dallas, OR, CCN 381308

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• Direct secure messaging: ghadeed386093@direct.salemhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• First Call Home Health Agency, LLC

  • Home Health Agency
  • Salem, OR
  • NPI 1740260801
  Care Compare affiliation
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  Care Compare affiliation

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

{
    "created_epoch": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1023438231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-353-5190",
            "fax_number": "314-353-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-353-5190",
            "fax_number": "314-353-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADEED",
        "first_name": "GWYN",
        "middle_name": "MAHONY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2022038658",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0059371",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL0006017",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO196254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWYN",
            "last_name": "MAHONY",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chasade Marie Hackney, FNP-C
• Labib F Haddad, M.D.
• Rita Haddad, MD
• Cassandra Jo Haddox, DO
• Mackenzie K Haddox
• Kyla Hadenfeldt, MSW, LCSW
• Bassam Ar Hadi, M.D
• Satvik Ramiah Hadigal, MD
• Lisa R Hadley, LPC
• Azra Hadziefendic

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.