Active NPI
Charlotte J Guest, MD
- Psychiatry Physician
- St Paul, MN
National Provider Identifier
1720052210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 40941
- Practice address
- 640 Jackson St
Mail Stop 11303a
St Paul, MN 55101-2502 - Phone
- (651) 254-4786
- Fax
- (651) 228-8362
- NPI assigned
- Feb 14, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 40941 | MN | Primary |
Addresses
Primary practice location
640 Jackson St
Mail Stop 11303a
St Paul, MN 55101-2502
Mailing address
1811 Weir Dr Ste 355
Woodbury, MN 55125-2273
Phone (651) 254-8580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 698318900 | Medicaid | MN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40941 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1720052210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 WEIR DR STE 355",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252273",
"telephone_number": "651-254-8580",
"fax_number": "651-730-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 JACKSON ST",
"address_2": "MAIL STOP 11303A",
"city": "ST PAUL",
"state": "MN",
"postal_code": "551012502",
"telephone_number": "651-254-4786",
"fax_number": "651-228-8362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEST",
"first_name": "CHARLOTTE",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "40941",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "698318900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.