Active NPI
Rick Cavins
- Psychologist
- Lake St Louis, MO
National Provider Identifier
1386722304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- MO SW 003127
- Practice address
- 1000 Lake Saint Louis Blvd
Suite 134
Lake St Louis, MO 63367-1340 - Phone
- (314) 616-6699
- Fax
- (636) 561-1665
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | MO SW 003127 | MO | Primary |
Addresses
Primary practice location
1000 Lake Saint Louis Blvd
Suite 134
Lake St Louis, MO 63367-1340
Mailing address
1000 Lake Saint Louis Blvd
Suite 134
Lake St Louis, MO 63367-1340
Phone (314) 616-6699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO SW 003127 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386722304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 LAKE SAINT LOUIS BLVD",
"address_2": "SUITE 134",
"city": "LAKE ST LOUIS",
"state": "MO",
"postal_code": "633671340",
"telephone_number": "314-616-6699",
"fax_number": "636-561-1665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 LAKE SAINT LOUIS BLVD",
"address_2": "SUITE 134",
"city": "LAKE ST LOUIS",
"state": "MO",
"postal_code": "633671340",
"telephone_number": "314-616-6699",
"fax_number": "636-561-1665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVINS",
"first_name": "RICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "MO SW 003127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.