Organization Active NPI

The Neuropsychology Center of St. Louis

  • Clinical Neuropsychologist
  • Creve Coeur, MO
National Provider Identifier
1043814874
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
THE NEUROPSYCHOLOGY CENTER OF ST. LOUIS
Practice address
425 N New Ballas Rd Ste 290
Creve Coeur, MO 63141-6852
Phone
(314) 324-3800
Fax
(314) 260-7676
NPI assigned
Nov 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Dr. Tammy A Martielli, PH.D.NPI 1104013689
Title
Neuropsychologist/Member
Phone
(314) 324-3800

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

425 N New Ballas Rd Ste 290
Creve Coeur, MO 63141-6852

Mailing address

425 N New Ballas Rd Ste 290
Creve Coeur, MO 63141-6852
Phone (314) 324-3800

National Provider Directory

National Provider Directory

Locations

425 N New Ballas Rd
Ste 290
Creve Coeur, MO 63141
Phone (314) 324-3800

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1043814874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD STE 290",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416852",
            "telephone_number": "314-324-3800",
            "fax_number": "314-260-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD STE 290",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416852",
            "telephone_number": "314-324-3800",
            "fax_number": "314-260-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NEUROPSYCHOLOGY CENTER OF ST. LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "MARTIELLI",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NEUROPSYCHOLOGIST/MEMBER",
        "authorized_official_telephone_number": "314-324-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.