NPIMap

Organization Active NPI

St. Croix Psychiatric, LLC

Doing business as PrairieCare Medical Group

  • Psychiatry Physician
  • Woodbury, MN
National Provider Identifier
1881849586
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ST. CROIX PSYCHIATRIC, LLC
Doing business as
PrairieCare Medical Group
Practice address
7616 Currell Blvd
Suite 100
Woodbury, MN 55125-2290
Phone
(651) 259-9700
Fax
(651) 259-9730
NPI assigned
Nov 21, 2008
Last updated
Feb 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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

Authorized official

Name
Mr. Stephen Roger Setterberg, M.D.NPI 1255493565
Title
President
Phone
(651) 259-9707

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 11

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Clinical Child & Adolescent Psychologist 103TC2200X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X NU
Psychiatric/Mental Health Registered Nurse 163WP0808X NU
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

7616 Currell Blvd
Suite 100
Woodbury, MN 55125-2290

Mailing address

7616 Currell Blvd
Suite 100
Woodbury, MN 55125-2290
Phone (651) 259-9700

Other names 1

  • PrairieCare Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091125000166 MN Part B Supplier - Clinic/Group Practice 9335288786 Receives reassigned benefits from 136 practitioners
Practice locations: Woodbury, MN; Rochester, MN; Plymouth, MN; Mankato, MN; Minnetonka, MN; Minneapolis, MN; Maple Grove, MN; Edina, MN…

National Provider Directory

National Provider Directory

Locations

6545 France Ave S
Ste 302
Edina, MN 55435
Phone (952) 230-9100

12915 63rd Ave N
Maple Grove, MN 55369
Phone (763) 383-5800

2001 Beam Ave
Maplewood, MN 55109
Phone (952) 737-4500

4510 77th St W
Minneapolis, MN 55435
Phone (952) 230-9100

5500 94th Ave N
Minneapolis, MN 55443
Phone (763) 762-6800

5255 Members Pkwy NW
Rochester, MN 55901
Phone (507) 218-3701

659 Bielenberg Dr
Ste 200
Woodbury, MN 55125
Phone (651) 259-9700

7616 Currell Blvd
Ste 100
Woodbury, MN 55125
Phone (651) 259-9700

7616 Currell Blvd
Ste 110
Woodbury, MN 55125
Phone (651) 259-9700

7616 Currell Blvd
Ste 130
Woodbury, MN 55125
Phone (651) 259-9700

Practitioners & affiliated clinicians

Practitioners 207

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.

View all 207

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234742400000",
    "number": "1881849586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7616 CURRELL BLVD",
            "address_2": "SUITE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252290",
            "telephone_number": "651-259-9700",
            "fax_number": "651-259-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7616 CURRELL BLVD",
            "address_2": "SUITE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252290",
            "telephone_number": "651-259-9700",
            "fax_number": "651-259-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX PSYCHIATRIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2009-02-16",
        "status": "A",
        "authorized_official_last_name": "SETTERBERG",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-259-9707",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrairieCare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.