Individual provider Active NPI

Ambreen Ahmed, MD

  • Psychiatry Physician
  • Sullivan, MO
National Provider Identifier
1376655746
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2008004908 Issued in MO
Practice address
101 Progress Pkwy
Sullivan, MO 63080-2359
Phone
(888) 403-1071
NPI assigned
Aug 31, 2006
Last updated
Apr 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2008004908 MO Primary
Child & Adolescent Psychiatry Physician 2084P0804X 2008004908 MO

Addresses

Primary practice location

101 Progress Pkwy
Sullivan, MO 63080-2359

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

704 E Highway 28
Owensville, MO 65066-1588
Phone (888) 403-1071

Other practice location 2

206 S Mill St
Eldon, MO 65026-1864
Phone (888) 403-1071

Other practice location 3

227 Metro Dr
Jefferson City, MO 65109-1134
Phone (888) 403-1071

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
I20090706000294 MO Practitioner - PsychiatryPractitioner - Neurology 8527119452 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008004908MOMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jan 1, 2012 Accepting new patients
Compass Health, Inc CurrentSince Jan 1, 2012 Accepting new patients
Pathways Psychiatric Hospital, Inc CurrentSince Jul 1, 2009 Accepting new patients
Pathways Psychiatric Hospital Inc CurrentSince Jul 1, 2009 Accepting new patients

Locations

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

1000 W Nifong Blvd
Bldg 6
Columbia, MO 65203
Phone (573) 443-7755

114 Downey Pl
Cuba, MO 65453
Phone (573) 885-3358

206 S Mill St
Eldon, MO 65026
Phone (573) 392-1828

1905 Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 634-3000

227 Metro Dr
Jefferson Cty, MO 65109
Phone (573) 634-3000

101 Hospital Dr
Osceola, MO 64776
Phone (417) 646-2054

704 E Highway 28
Owensville, MO 65066
Phone (573) 437-2959

101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555

307 N Main St
Windsor, MO 65360
Phone (660) 647-2182

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1376655746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131",
            "fax_number": "816-318-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROGRESS PKWY",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802359",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 E Highway 28",
            "address_purpose": "LOCATION",
            "city": "Owensville",
            "state": "MO",
            "postal_code": "650661588",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 S Mill St",
            "address_purpose": "LOCATION",
            "city": "Eldon",
            "state": "MO",
            "postal_code": "650261864",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "227 Metro Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651091134",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "AMBREEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2008004908",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "2008004908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, MO

Sources for this page

Verify at the official NPI Registry.