Bex Wilde

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4273 Issued in MN

Practice address

2157 Geranium Ave E
Saint Paul, MN 55119-3345

Phone

(503) 949-0400

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Marriage and Family Therapist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edges Wellness Center LLCGroup PAC ID 9638613607, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Edges Wellness Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1306389861

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1609630458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 GERANIUM AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193345",
            "telephone_number": "503-949-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 GERANIUM AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193345",
            "telephone_number": "503-949-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "BEX",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild River Services Inc
• Wild Tree Psychotherapy, LLC
• Diane M Wild, CRNA
• Laura Wild, D.D.S.
• Rebecca Wild Wild, RN
• Morell Marie Wilde
• Wildenauer Chiropractic Clinic LTD
• Ulanda D Wiley, CPRS SUPERVISOR
• Jennifer Wilhelmy, CPNP
• Kimberly Ann Wilke

• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.