Active NPI
Carolyn Jean Reabe, MD
- Addiction Psychiatry Physician
- Columbus, WI
National Provider Identifier
1235109638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Psychiatry Physician
- License
- 51265-20
- Practice address
- 1515 Park Ave
Columbus, WI 53925-2402 - Phone
- (920) 623-2200
- NPI assigned
- Jan 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 51265-20 | WI | Primary |
Addresses
Primary practice location
1515 Park Ave
Columbus, WI 53925-2402
Mailing address
1515 Park Ave
Columbus, WI 53925-2402
Phone (920) 623-2200
Other names 1
- Carolyn Jean Baxter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Oklahoma College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51265-20 | WI | MD | Addiction Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Ridge Health, Inc. | Current | Accepting new patients | |
| Prairie Ridge Health, Inc. | Current | Accepting new patients | |
| Prairie Ridge Health Inc. | Current | Accepting new patients | |
| Bridgepoint Health LLC | Past | Accepting new patients | |
| St. John Physicians, Inc. | Past | Accepting new patients | |
| Jeffrey K McIlroy MD Inc | Past | Accepting new patients |
Locations
1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200
Interoperability endpoints
- creabe434023@direct-ehr-ssmhc.com
Organizations & group practices 7
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.
-
- Critical Access Hospital
- Columbus, WI
- NPI 1154403657
-
- Critical Access Hospital
- Columbus, WI
- NPI 1841376183
-
- Family Medicine Physician
- Sun Prairie, WI
- NPI 1699534545
-
- Orthopaedic Surgery Physician
- Columbus, WI
- NPI 1912329335
-
- Mental Health Counselor
- Sheboygan, WI
- NPI 1760593727
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Claremore, OK
- NPI 1053531830
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1336194406
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Columbus, WI
- NPI 1154403657
-
- Critical Access Hospital
- Columbus, WI
- NPI 1841376183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1235109638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 PARK AVE",
"city": "COLUMBUS",
"state": "WI",
"postal_code": "539252402",
"telephone_number": "920-623-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 PARK AVE",
"city": "COLUMBUS",
"state": "WI",
"postal_code": "539252402",
"telephone_number": "920-623-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REABE",
"first_name": "CAROLYN",
"middle_name": "JEAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-26",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "WI",
"license": "51265-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "BAXTER",
"middle_name": "JEAN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Columbus, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.