Stephanie Jallen, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

13695 Issued in ND

Practice address

900 E Broadway Ave
Bismarck, ND 58501-4520

Phone

(701) 530-7300

NPI assigned

Jun 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Badlands Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dickinson, ND
  • NPI 1124072525
  Medicare reassignment NPD
• Lake Region Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Devils Lake, ND
  • NPI 1669411930
  Medicare reassignment NPD
• Life Skills and Transition Center

  • Intellectual Disabilities Intermediate Care Facility
  • Grafton, ND
  • NPI 1558427708
  Medicare reassignment NPD
• North Central Behavioral Health Clinic

  • Clinic/Center
  • Minot, ND
  • NPI 1477592533
  Medicare reassignment NPD
• Northeast Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Forks, ND
  • NPI 1366496341
  Medicare reassignment NPD
• Northwest Behavioral Health Clinic

  • Adult Mental Health Clinic/Center
  • Williston, ND
  • NPI 1770524613
  Medicare reassignment NPD
• South Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jamestown, ND
  • NPI 1225075906
  Medicare reassignment NPD
• Southeast Behavioral Health Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fargo, ND
  • NPI 1932146941
  Medicare reassignment NPD
• St. Alexius Medical Center

  • Specialist
  • Bismarck, ND
  • NPI 1205868429
  Medicare reassignment NPD
• West Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bismarck, ND
  • NPI 1649226713
  Medicare reassignment NPD
• Northeast Human Service Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Grand Forks, ND
  • NPI 1891808978
  NPD
• St Alexius Medical Center

  • Home Infusion Therapy Pharmacy
  • Bismarck, ND
  • NPI 1063663607
  NPD

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1245541895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 997",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585020997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLEN",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "ND",
            "license": "13695",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME116874",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81891",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara Jahner, FNP-C
• Joseph Jahner
• Kiah Jahner
• Joel B Jahnke, PT
• Sunanda Jain, MD
• Alpha S Jalloh
• Henrietta James
• Jamal M James, ATC-L
• Muhammad O. Jamil, M.D., MBBS
• Emily Janes, DNP, APRN

• Child & Adolescent Psychiatry Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Child & Adolescent Psychiatry Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.