Highland Psychiatric Services PA

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

Legal business name

HIGHLAND PSYCHIATRIC SERVICES PA

Practice address

897 St Paul Ave
St Paul, MN 55116

Phone

(651) 698-4443

Fax

(651) 698-4817

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Suzy Ellen Peterson, DONPI 1114961372

Title

Owner

Phone

(651) 698-4443

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzy E Peterson, DO

  • Child & Adolescent Psychiatry Physician
  • Minneapolis, MN
  • NPI 1114961372
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891884326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 ST PAUL AVE",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "651-698-4443",
            "fax_number": "651-698-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 ST PAUL AVE",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "651-698-4443",
            "fax_number": "651-698-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PSYCHIATRIC SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SUZY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-698-4443",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Highland Chiropractic Center, P.a
• Highland GW, LLC
• Highland Operations LLC
• Highland Park Counseling Associates LLC
• Highland Park Ops LLC
• Ethan Land Hight, MD
• Highview Assisted Living LLC
• Ezra Hilber
• Kali Hildebrand, DDS
• Megan Marie Hilden Rondeau, RN, CPNP

• Child & Adolescent Psychiatry Physician in St Paul, MN
• Providers in St Paul, MN by specialty
• Child & Adolescent Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.