Individual provider Active NPI

Colleen Teresa Loehr, M.D.

  • Psychiatry Physician
  • Jefferson City, MO
National Provider Identifier
1073689337
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
113480 Issued in MO
Practice address
2013 Williams St
Jefferson City, MO 65109-4771
Phone
(573) 636-8108
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

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
Psychiatry Physician 2084P0800X 113480 MO Primary

Addresses

Primary practice location

2013 Williams St
Jefferson City, MO 65109-4771

Mailing address

2305 Plymouth Rock Dr
Jefferson City, MO 65109-2087
Phone (573) 635-4303

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051122000201 MO Practitioner - Psychiatry 8123047966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Massachusetts Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of MissouriGroup PAC ID 1456254226, 48 clinicians

Practice addresses (Care Compare)

600 E 5TH St
Fulton State Hospital
Fulton, MO 65251-1793
Phone (573) 592-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113480MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Psychiatry CurrentSince Feb 4, 2023 Accepting new patients
State of Missouri Psychiatry CurrentSince Feb 4, 2023 Accepting new patients
SSM Regional Health Services PastSince Dec 22, 2013 Accepting new patients
SSM Regional Health Services Past Accepting new patients
New Horizons Community Support Services, Inc. PastSince Mar 12, 2018 Accepting new patients

Locations

600 E 5th St
Fulton, MO 65251
Phone (573) 592-2623

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073689337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 PLYMOUTH ROCK DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092087",
            "telephone_number": "573-635-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 WILLIAMS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094771",
            "telephone_number": "573-636-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEHR",
        "first_name": "COLLEEN",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "113480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.