Syed Shahid Mumtaz MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD114459 Issued in MO

Legal business name

SYED SHAHID MUMTAZ MD

Practice address

17269 Wild Horse Creek Rd
#250
Chesterfield, MO 63005-1360

Phone

(636) 519-7404

Fax

(636) 537-0043

NPI assigned

Sep 30, 2016

Organization subpart

Yes

Parent organization

CHESTERFIELD VALLEY PSYCHIATRYAs reported in NPPES

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

Authorized official

Name

Dr. Syed Shahid Mumtaz, MD

Title

Owner

Phone

(636) 519-7404

Specialties & licenses 1

Addresses

Other names 1

• Chesterfield Valley Psychiatry Doing business as

Part of

Syed Shahid Mumtaz MD

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacey Ann Roth, LPC

  • Professional Counselor
  • House Springs, MO
  • NPI 1659359800
  NPD (past)

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1225587272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17269 WILD HORSE CREEK RD",
            "address_2": "#250",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051360",
            "telephone_number": "636-519-7404",
            "fax_number": "636-537-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17269 WILD HORSE CREEK RD",
            "address_2": "#250",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051360",
            "telephone_number": "636-519-7404",
            "fax_number": "636-537-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYED SHAHID MUMTAZ MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHESTERFIELD VALLEY PSYCHIATRY",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "MUMTAZ",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "SHAHID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-519-7404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "MD114459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesterfield Valley Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Star Lynn Sutton, COTA/L
• Jocelyn Swan, LPC
• Joseph Jeff Sweet, PA
• Justin Lucas Sweetin, CNP
• Runa Akter Swity, MD
• Sofia Syed, DPT
• Sarah Sykes, LMSW
• Keaton Taber
• Madeline Taber, DO
• Kristie Marie Taggart, PNP

• Child & Adolescent Psychiatry Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Child & Adolescent Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.