Individual provider Active NPI

Margaret Wetherford Rissman, PH.D.

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1073659165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00928 Issued in MO
Practice address
2025 S Brentwood Blvd Ste 206
Saint Louis, MO 63144-1851
Phone
(314) 962-0008
Fax
(314) 963-8950
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00928 MO Primary

Addresses

Primary practice location

2025 S Brentwood Blvd Ste 206
Saint Louis, MO 63144-1851

Mailing address

2025 S Brentwood Blvd Ste 206
Saint Louis, MO 63144-1851
Phone (314) 962-0008

Other identifiers 1

IdentifierTypeStateIssuer
109458OtherMOBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
00928MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Learning Consultants, Inc. 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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073659165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S BRENTWOOD BLVD STE 206",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441851",
            "telephone_number": "314-962-0008",
            "fax_number": "314-963-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S BRENTWOOD BLVD STE 206",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441851",
            "telephone_number": "314-962-0008",
            "fax_number": "314-963-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSMAN",
        "first_name": "MARGARET",
        "middle_name": "WETHERFORD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "00928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "109458",
            "state": "MO"
        }
    ],
    "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.

Verify at the official NPI Registry.