Bradley G Nevins, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1436-057 Issued in WI

Practice address

204 S Adams St
Saint Croix Falls, WI 54024-9449

Phone

(715) 483-3221

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Group practices

Allied Mental Health Specialty Group SCGroup PAC ID 9234155136, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Allied Mental Health Specialty Group SC

  • Psychologist
  • Hudson, WI
  • NPI 1831315191
  Medicare reassignment Care Compare group Authorized official
• Familymeans

  • Mental Health Counselor
  • Stillwater, MN
  • NPI 1881690899
  NPD (past)
• Refresh in-Home Counseling LLC

  • Clinical Social Worker
  • Antioch, IL
  • NPI 1609365519
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336248137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S ADAMS ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540249449",
            "telephone_number": "715-483-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S ADAMS ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540249449",
            "telephone_number": "715-483-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVINS",
        "first_name": "BRADLEY",
        "middle_name": "G",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1436-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  FACILITY",
            "identifier": "31G80NE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165875100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "NA9031023578",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39087700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  PRO FEE",
            "identifier": "86D52NE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP30609",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "620006571",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rene Brian Milner, M.D.
• Ashlyn Andrea Mortel, RDH
• Stephanie June Mysicka, NP
• Vittal Ramachandra Nagar, M.D
• Cynthia Nelson
• Glenn A Nickele, MD
• Mollisa A Noel, DPT
• David Nordin, M.D.
• McKenzy Norgard, PA-C
• Amanda Novak

• Psychologist in Saint Croix Falls, WI
• Providers in Saint Croix Falls, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.