Active NPI
Jerry Dunn, PH.D
- Clinical Psychologist
- Saint Louis, MO
National Provider Identifier
1003948621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2003023849
- Practice address
- 1 University Blvd
Saint Louis, MO 63121-4400 - Phone
- (314) 516-7342
- Fax
- (314) 516-6624
- NPI assigned
- Mar 9, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2003023849 | MO | Primary |
Addresses
Primary practice location
1 University Blvd
Saint Louis, MO 63121-4400
Mailing address
473 Governor Dr
Ballwin, MO 63021-6374
Phone (636) 227-5334
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003023849 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003948621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "473 GOVERNOR DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630216374",
"telephone_number": "636-227-5334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 UNIVERSITY BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631214400",
"telephone_number": "314-516-7342",
"fax_number": "314-516-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "JERRY",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2003023849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.