Individual provider Active NPI

Stephen J. Wieder, MD

  • Psychiatry Physician
  • Napa, CA
National Provider Identifier
1679680771
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G29990 Issued in CA
Practice address
2100 Napa Vallejo Hwy
Napa, CA 94558-6293
Phone
(707) 253-5000
Fax
(978) 462-3496
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 38697 MA
Child & Adolescent Psychiatry Physician 2084P0804X 38697 MA
Psychiatry Physician 2084P0800X G29990 CA Primary

Addresses

Primary practice location

2100 Napa Vallejo Hwy
Napa, CA 94558-6293

Mailing address

2100 Napa Vallejo Hwy
Napa, CA 94558-6293
Phone (707) 253-5000

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

State licenses

LicenseStateTypeSpecialty
G29990CAMDPsychiatry Physician
38697MAMDPsychiatry Physician
29990CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Behavioral Health Corporation CurrentSince Jun 24, 2010 Accepting new patients
Harborside of Newburyport, Inc. PastSince Oct 23, 1995 Accepting new patients
Northeast Hospital Corporation PastSince Jun 24, 2010 Accepting new patients

Locations

199 Rosewood Dr
Ste 250
Danvers, MA 01923
Phone (978) 867-7756

60 Merrimack St
Haverhill, MA 01830
Phone (978) 373-1126

25R Market St
Ipswich, MA 01938
Phone (978) 356-1776

12 Methuen St
Ste 3
Lawrence, MA 01840
Phone (978) 683-3128

52 Inn St
Newburyport, MA 01950
Phone (978) 462-4644

41 Mason St
Salem, MA 01970
Phone (978) 777-1585

Organizations & group practices 3

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1679680771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NAPA VALLEJO HWY",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586293",
            "telephone_number": "707-253-5000",
            "fax_number": "978-462-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NAPA VALLEJO HWY",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586293",
            "telephone_number": "707-253-5000",
            "fax_number": "978-462-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDER",
        "first_name": "STEPHEN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "38697",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "38697",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G29990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.