Individual provider Active NPI

Cherie A Baetz-Davis, PH.D.

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1366437196
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
01638 Issued in MO
Practice address
331 N New Ballas Rd Unit 410062
Saint Louis, MO 63141-0062
Phone
(314) 804-3624
Fax
(314) 804-5336
NPI assigned
Sep 19, 2005
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 01638 MO Primary

Addresses

Primary practice location

331 N New Ballas Rd Unit 410062
Saint Louis, MO 63141-0062

Mailing address

211 Carrollton LN
Saint Louis, MO 63135-1225
Phone (314) 804-3624

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000092 MO Practitioner - Clinical Psychologist 2163472515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

331 N New Ballas Rd
Unit 410062
Creve Coeur, MO 63141-5505
Phone (314) 804-3624

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherie Baetz-Davis, PH.D., LLC Psychologist CurrentSince Nov 9, 2012 Accepting new patients
County of St Louis Division of Fiscal Management Past Accepting new patients

Locations

12645 Olive Blvd
Ste 200
Saint Louis, MO 63141

331 N New Ballas Rd
Unit 410062
Saint Louis, MO 63141
Phone (314) 804-3624

655 Craig Rd
Ste 128
Saint Louis, MO 63141
Phone (314) 973-2091

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1366437196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CARROLLTON LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631351225",
            "telephone_number": "314-804-3624",
            "fax_number": "314-804-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 N NEW BALLAS RD UNIT 410062",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631410062",
            "telephone_number": "314-804-3624",
            "fax_number": "314-804-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAETZ-DAVIS",
        "first_name": "CHERIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "01638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.