Individual provider Active NPI

Nancy Lynn Friesen, PH.D.

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1588721880
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2005038105 Issued in MO
Practice address
12141 Ladue Rd
Saint Louis, MO 63141-8120
Phone
(314) 878-4340
Fax
(314) 878-4524
NPI assigned
Jan 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2005038105 MO Primary

Addresses

Primary practice location

12141 Ladue Rd
Saint Louis, MO 63141-8120

Mailing address

12141 Ladue Rd
Saint Louis, MO 63141-8120
Phone (314) 878-4340

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
I20231013000689 MO Practitioner - Clinical Psychologist 9234584079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1438 S Grand Blvd
Saint Louis, MO 63104-1027
Phone (314) 977-6082

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005038105MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Oct 1, 2023 Accepting new patients
SSM Health Care Group CurrentSince Oct 1, 2023 Accepting new patients

Locations

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1438 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 977-4828

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588721880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12141 LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418120",
            "telephone_number": "314-878-4340",
            "fax_number": "314-878-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12141 LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418120",
            "telephone_number": "314-878-4340",
            "fax_number": "314-878-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESEN",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2005038105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.