Individual provider Active NPI

Scott J Symes, PSY.D.

  • Clinical Psychologist
  • Lee's Summit, MO
National Provider Identifier
1063496487
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2004013232 Issued in MO
Practice address
3367 NE Ralph Powell Rd
Lees Summit, MO 64064-2368
Phone
(816) 246-0111
Fax
(866) 335-7993
NPI assigned
Nov 30, 2005
Last updated
Dec 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2004013232 MO Primary

Addresses

Primary practice location

3367 NE Ralph Powell Rd
Lees Summit, MO 64064-2368

Mailing address

3367 NE Ralph Powell Rd
Lees Summit, MO 64064-2368
Phone (816) 246-0111

Other identifiers 1

IdentifierTypeStateIssuer
495979718MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041102000008 MO Practitioner - Clinical Psychologist 3971575192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rejuvenate, IncGroup PAC ID 0244395762, 4 clinicians

Practice addresses (Care Compare)

400 SW Longview Blvd
Suite 160
Lees Summit, MO 64081-2112
Phone (816) 761-3944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Mental Health Associates, Inc. Clinical Past Accepting new patients
Compass Health, Inc Past Accepting new patients
Allied Mental Health Consultants LLC PastSince Aug 18, 2015 Accepting new patients
Corley Counseling LLC PastSince Aug 15, 2021 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230595200000",
    "number": "1063496487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3367 NE RALPH POWELL RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642368",
            "telephone_number": "816-246-0111",
            "fax_number": "866-335-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3367 NE RALPH POWELL RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642368",
            "telephone_number": "816-246-0111",
            "fax_number": "866-335-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMES",
        "first_name": "SCOTT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2004013232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495979718",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.