NPIMap

Organization Active NPI

Stone Creek Psychiatry, LLC

  • Psychiatry Physician
  • Chanhassen, MN
National Provider Identifier
1548534191
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
STONE CREEK PSYCHIATRY, LLC
Practice address
7945 Stone Creek Dr
Suite 130
Chanhassen, MN 55317-4605
Phone
(952) 241-4050
Fax
(952) 241-4049
NPI assigned
Feb 29, 2012
Last updated
Feb 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Thomas Winegarden, MBNPI 1194707828
Title
Owner
Phone
(952) 241-4050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

7945 Stone Creek Dr
Suite 130
Chanhassen, MN 55317-4605

Mailing address

7945 Stone Creek Dr
Suite 130
Chanhassen, MN 55317-4605
Phone (952) 241-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120730000592 MN Part B Supplier - Clinic/Group Practice 2365608726 Receives reassigned benefits from 7 practitioners
Practice locations: Chanhassen, MN

National Provider Directory

National Provider Directory

Locations

7945 Stone Creek Dr
Ste 130
Chanhassen, MN 55317
Phone (952) 241-4050

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1548534191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 STONE CREEK DR",
            "address_2": "SUITE 130",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174605",
            "telephone_number": "952-241-4050",
            "fax_number": "952-241-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 STONE CREEK DR",
            "address_2": "SUITE 130",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174605",
            "telephone_number": "952-241-4050",
            "fax_number": "952-241-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE CREEK PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "WINEGARDEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-241-4050",
        "authorized_official_credential": "MB"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.