Active NPI
Saundra Welter Bacon, PSY.D., LP
- Psychologist
- Hastings, MN
National Provider Identifier
1982833570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP5440
- Practice address
- 1250 N Frontage Rd Ste 202
Hastings, MN 55033-1519 - Phone
- (651) 226-1299
- NPI assigned
- Jul 6, 2009
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP5440 | MN | Primary |
Addresses
Primary practice location
1250 N Frontage Rd Ste 202
Hastings, MN 55033-1519
Mailing address
1250 N Frontage Rd Ste 202
Hastings, MN 55033-1519
Phone (651) 226-1299
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5440 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Birbilis and Associates, P.a. | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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": "1246838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1982833570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 N FRONTAGE RD STE 202",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550331519",
"telephone_number": "651-226-1299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 N FRONTAGE RD STE 202",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550331519",
"telephone_number": "651-226-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELTER BACON",
"first_name": "SAUNDRA",
"name_prefix": "Dr.",
"credential": "PSY.D., LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-06",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hastings, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.