Individual provider Active NPI

Gordon H. Robinson, M.D.

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1245342161
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD100250 Issued in MO
Practice address
1170 Old Ballas Road
Suite 110
St. Louis, MO 63141
Phone
(314) 567-1958
Fax
(314) 567-0037
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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 MD100250 MO Primary

Addresses

Primary practice location

1170 Old Ballas Road
Suite 110
St. Louis, MO 63141

Mailing address

11710 Old Ballas Rd
Ste 110
Creve Coeur, MO 63141-7076
Phone (314) 567-5000

Other identifiers 3

IdentifierTypeStateIssuer
105460OtherMOBLUE CROSS BLUE SHIELD
229025OtherMOHEALTHLINK
260029804OtherMORR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091030000425 MO Practitioner - Psychiatry 0547307183 Reassigns benefits to 1 organization
I20201117003307 IL Practitioner - Psychiatry 0547307183

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Washington University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gateway Psychiatric Group LLCGroup PAC ID 5991944829, 3 clinicians

Practice addresses (Care Compare)

11124 S Towne SQ
Suite 100
Saint Louis, MO 63123-7815
Phone (314) 567-1958

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD100250MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Behavioral Consultants, Inc. Psychiatry PastSince Dec 31, 1991 Accepting new patients
Gateway Psychiatric Group, LLC Past Accepting new patients
Lutheran Family and Children's Services of Missouri PastSince Jun 19, 2007 Accepting new patients
Community Alternatives, Inc. Past Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1245342161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 OLD BALLAS RD",
            "address_2": "STE 110",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-567-5000",
            "fax_number": "314-567-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 OLD BALLAS ROAD",
            "address_2": "SUITE 110",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-567-1958",
            "fax_number": "314-567-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "GORDON",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "MD100250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "105460",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "229025",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "260029804",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.