Gwen A Stein, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

37744 Issued in MN

Practice address

400 Annandale Blvd
Annandale, MN 55302

Phone

(651) 259-3850

NPI assigned

May 17, 2006

Last updated

May 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Behavioral Health Hospital Alexandria

  dba CBHH Alexandria

  • Psychiatric Hospital
  • Alexandria, MN
  • NPI 1386676799
  NPD (past)
• Community Behavioral Health Hospital Annandale

  dba CBHH Annandale

  • Psychiatric Hospital
  • Annandale, MN
  • NPI 1225130487
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1801848635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 1ST ST",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671408",
            "telephone_number": "320-589-7625",
            "fax_number": "320-589-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ANNANDALE BLVD",
            "city": "ANNANDALE",
            "state": "MN",
            "postal_code": "55302",
            "telephone_number": "651-259-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Morris",
            "state": "MN",
            "postal_code": "562671408",
            "country_code": "US",
            "telephone_number": "320-589-7625",
            "fax_number": "320-589-7686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEIN",
        "first_name": "GWEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "13887",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "37744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28T44HO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "585241010541",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358217500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Annandale, MN
• Providers in Annandale, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.