Ellen Lockard Edens, MD, MPE, MA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2004004159 Issued in MO

Practice address

3165 McKelvey Rd
Suite 200
Bridgeton, MO 63044-2550

Phone

(314) 206-3900

Fax

(314) 206-3992

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1215943147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST",
            "address_2": "SUITE 500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032303",
            "telephone_number": "314-206-3724",
            "fax_number": "314-206-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 MCKELVEY RD",
            "address_2": "SUITE 200",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442550",
            "telephone_number": "314-206-3900",
            "fax_number": "314-206-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENS",
        "first_name": "ELLEN",
        "middle_name": "LOCKARD",
        "name_prefix": "Dr.",
        "credential": "MD, MPE, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2004004159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CHI Duong-Nguyen, RPH
• Tessa Durell
• Megan E Durham, BA
• Kaitlynn Dutzy
• Ebony Therapy LLC
• Terry R Egan, DDS
• Teide Brisibe Ehimare, M.D.
• Norman J Ehlinger Jr., DO
• Craig Gerard Elinor, DMD
• Laura Elliott, FNP-C

• Psychiatry Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.