Active NPI
Gail Elaine Baldwin, MD
- Family Medicine Physician
- Duluth, MN
National Provider Identifier
1508827130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 33475
- Practice address
- 4325 Grand Ave
Duluth, MN 55807-2730 - Phone
- (218) 624-6584
- Fax
- (715) 392-1935
- NPI assigned
- Mar 31, 2006
- Last updated
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 33475 | MN | Primary |
| Family Medicine Physician | 207Q00000X | 40624 020 | WI |
Addresses
Primary practice location
4325 Grand Ave
Duluth, MN 55807-2730
Mailing address
PO Box 38
South Range, WI 54874-0038
Phone (218) 624-6584
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31850400 | Medicaid | WI | |
| 40624 020 | Other | WI | LICENSE |
| 33475 | Other | MN | LICENSE |
| 756202100 | Medicaid | MN |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150701001028 | WI | Order and Referring Only - Family Practice | 8224051867 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40624 020 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1508827130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 38",
"city": "SOUTH RANGE",
"state": "WI",
"postal_code": "548740038",
"telephone_number": "218-624-6584",
"fax_number": "715-392-1901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4325 GRAND AVE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558072730",
"telephone_number": "218-624-6584",
"fax_number": "715-392-1935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDWIN",
"first_name": "GAIL",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "33475",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "40624 020",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31850400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "40624 020",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "33475",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "756202100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.