Southpointe Psychiatry & Wellness, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SOUTHPOINTE PSYCHIATRY & WELLNESS, LLC

Practice address

135 Technology Dr Ste 204
Canonsburg, PA 15317-9549

Phone

(724) 399-3931

Fax

(866) 601-3186

NPI assigned

Jun 10, 2024

Organization subpart

No

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

Authorized official

Name

Collette Gibbons, CRNP

Title

Member

Phone

(724) 399-3931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexandria Rae Baker

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, PA
  • NPI 1912691205
  Medicare reassignment NPD
• Jennifer A. Bowman, DNP, MBA, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Canonsburg, PA
  • NPI 1003218280
  NPD (past)

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1487496493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 TECHNOLOGY DR STE 204",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179549",
            "telephone_number": "724-399-3931",
            "fax_number": "866-601-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 TECHNOLOGY DR STE 204",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179549",
            "telephone_number": "724-399-3931",
            "fax_number": "866-601-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPOINTE PSYCHIATRY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "COLLETTE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "724-399-3931",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Hills Eye Associates, LTD. (South Hills Optical)
• South Hills Opco LLC
• South Hills Operations LLC (South Hills Rehabilitation and Wellness Center)
• South Hills Rehabilitation & Nursing LLC
• Southpointe Chiropractic and Fitness
• Southwood Psychiatric Hospital, LLC (Southwood Children's Behavioral Healthcare)
• Robyn Lynn Stechly, CRNP
• Megan Elizabeth Steen
• Jonathan F Stein, D.C.
• Steven J Speca DMD LLC (Dental Anesthesia Solutions)

• Psychiatric/Mental Health Nurse Practitioner in Canonsburg, PA
• Providers in Canonsburg, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.