NPIMap

Organization Active NPI

State of Missouri

  • Case Management Agency
  • Saint Louis, MO
National Provider Identifier
1437360260
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
STATE OF MISSOURI
Practice address
1901 Pennsylvania Ave
Saint Louis, MO 63133-1325
Phone
(314) 512-7800
NPI assigned
May 24, 2007
Organization subpart
Yes
Parent organization
STATE OF MISSOURIAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Molly Jane Boeckmann
Title
Director of Administrative Services
Phone
(573) 751-4055

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Southwest Missouri Psy (104 organizations share this tax ID)
Part of
Southwest Missouri Psy

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1901 Pennsylvania Ave
Saint Louis, MO 63133-1325

Mailing address

1706 E Elm St
Jefferson City, MO 65101-4130
Phone (573) 751-3398

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
156175408MedicaidMO

Other names 1

NPPES NPI Registry
  • Hawthorn Children's Psychiatric Hosptial Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2020.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1437360260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 E ELM ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651014130",
            "telephone_number": "573-751-3398",
            "fax_number": "573-526-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 PENNSYLVANIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631331325",
            "telephone_number": "314-512-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSOURI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF MISSOURI",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "BOECKMANN",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "573-751-4055"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156175408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawthorn Children's Psychiatric Hosptial",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hawthorn Children's Psychiatric Hosptial",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 31, 2020; 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.