Individual provider Active NPI

Gwendolyn Alice Halsted, MD

  • Family Medicine Physician
  • Richmond, IN
National Provider Identifier
1467542167
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01035332A Issued in IN
Practice address
203 East Main Street
Richmond, IN 47374
Phone
(765) 973-9294
Fax
(765) 973-9233
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01035332A IN Primary

Addresses

Primary practice location

203 East Main Street
Richmond, IN 47374

Mailing address

203 East Main Street
Richmond, IN 47374
Phone (765) 973-9294

Other identifiers 1

IdentifierTypeStateIssuer
100321430AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ghalsted307770@ecommunitydirect.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1467542167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 EAST MAIN STREET",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "47374",
            "telephone_number": "765-973-9294",
            "fax_number": "765-973-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 EAST MAIN STREET",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "47374",
            "telephone_number": "765-973-9294",
            "fax_number": "765-973-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTED",
        "first_name": "GWENDOLYN",
        "middle_name": "ALICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01035332A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100321430A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.