Organization Active NPI

Paul M. Packman Inc.

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1366692303
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
29193 Issued in MO
Legal business name
PAUL M. PACKMAN INC.
Practice address
8301 Maryland Ave.
Suite 320
St. Louis, MO 63105
Phone
(314) 727-1666
Fax
(314) 727-5488
NPI assigned
Sep 26, 2008
Last updated
Sep 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Dr. Paul Michael Packman, M.D.
Title
President
Phone
(314) 727-1666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 29193 MO Primary

Addresses

Primary practice location

8301 Maryland Ave.
Suite 320
St. Louis, MO 63105

Mailing address

8301 Maryland Ave
Suite 320
St. Louis, MO 63105
Phone (314) 727-1666

Other identifiers 3

IdentifierTypeStateIssuer
826262307OtherMORAILROAD MEDICARE
200743300MedicaidMO
000005191OtherMOMO MEDICARE SERVICES

National Provider Directory

National Provider Directory

Locations

1034 S Brentwood Blvd
Ste 1180
Saint Louis, MO 63117
Phone (314) 727-1666

8301 Maryland Ave
Ste 320
Saint Louis, MO 63105
Phone (314) 727-1666

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1366692303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 MARYLAND AVE",
            "address_2": "SUITE 320",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63105",
            "telephone_number": "314-727-1666",
            "fax_number": "314-727-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 MARYLAND AVE.",
            "address_2": "SUITE 320",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63105",
            "telephone_number": "314-727-1666",
            "fax_number": "314-727-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M. PACKMAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "PACKMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-727-1666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "29193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "826262307",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200743300",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO MEDICARE SERVICES",
            "identifier": "000005191",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.