Individual provider Active NPI

Veera N. Reddy, M.D.

  • Psychiatry Physician
  • Farmington, MO
National Provider Identifier
1336257237
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
105498 Issued in MO
Practice address
1010 W Columbia St
Southeast Missouri Mental Health Center
Farmington, MO 63640-2902
Phone
(573) 218-6792
Fax
(573) 218-6703
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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 105498 MO Primary

Addresses

Primary practice location

1010 W Columbia St
Southeast Missouri Mental Health Center
Farmington, MO 63640-2902

Mailing address

1085 Maple St
Farmington, MO 63640-1955
Phone (573) 756-5353

Other identifiers 2

IdentifierTypeStateIssuer
105498OtherMOMO PROFESSIONAL LICENSE
206977142MedicaidMO

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
I20040218000955 MO Practitioner - Psychiatry 1557256583 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BJC Behavioral Health CurrentSince Aug 22, 2011 Accepting new patients
State of Missouri Psychiatry CurrentSince Nov 10, 2003 Accepting new patients
State of Missouri Psychiatry CurrentSince Nov 10, 2003 Accepting new patients
BJC Behavioral Health Current Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1085 Maple St
Farmington, MO 63640
Phone (573) 756-5353

1010 W Columbia St
Farmington, MO 63640
Phone (573) 218-6792

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

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southeast Missouri Mental Health CenterFarmington, MO, CCN 264005 Hospital W-2 Managing Employee Jan 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1336257237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 MAPLE ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401955",
            "telephone_number": "573-756-5353",
            "fax_number": "573-756-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W COLUMBIA ST",
            "address_2": "SOUTHEAST MISSOURI MENTAL HEALTH CENTER",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402902",
            "telephone_number": "573-218-6792",
            "fax_number": "573-218-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "VEERA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "105498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO PROFESSIONAL LICENSE",
            "identifier": "105498",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206977142",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.