Gregory Warren Mattingly, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

102964 Issued in MO

Practice address

330 1St Capitol Dr
Ste 390
Saint Charles, MO 63301-2852

Phone

(636) 949-5760

Fax

(636) 949-0729

NPI assigned

Jun 23, 2005

Last updated

Jan 26, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Psychiatry

Education

Washington University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Charles Psychiatric Associates, Inc.Group PAC ID 0648431312, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: saintcharlespsychiatricassociates.gregorymattingly@152459.advancedmd-direct.com

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.

• St. Charles Psychiatric Associates, Inc.

  • Specialist
  • Weldon Spring, MO
  • NPI 1164631495
  Medicare reassignment Care Compare group NPD
• Changing Your Beliefs to a Better Life, LLC

  dba Mesey

  • Professional Counselor
  • Saint Charles, MO
  • NPI 1982256418
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1215933379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 WELDON SPRING PKWY",
            "address_2": "STE 300",
            "city": "WELDON SPRING",
            "state": "MO",
            "postal_code": "633049101",
            "telephone_number": "636-949-5760",
            "fax_number": "636-949-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 1ST CAPITOL DR",
            "address_2": "STE 390",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012852",
            "telephone_number": "636-949-5760",
            "fax_number": "636-949-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "GREGORY",
        "middle_name": "WARREN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "102964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "17646",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "212683",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan H. Mass, MD
• Anthony Massarella, BC- H.I.S.
• Irim A. Massay, MD
• Brandi Lynn Mathis, COTA/L
• Candice Mathis, DC
• Maria Maull, RPH
• Jennifer Maupin, LPC
• James Howard Maurer, M.D.
• Sarah B Maurer, LPC, CCDP-D
• Kathryn Rose Maus

• Psychiatry Physician in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.