Active NPI
Courtney Paige Wall, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1639796766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2020019958
- Practice address
- 2650 Olive St
Saint Louis, MO 63103-1489 - Phone
- (314) 533-8200
- NPI assigned
- Jul 6, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2020019958 | MO | Primary |
Addresses
Primary practice location
2650 Olive St
Saint Louis, MO 63103-1489
Mailing address
2650 Olive St
Saint Louis, MO 63103-1424
Other names 1
- Miss Courtney Paige Schult
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2650 Olive St
Saint Louis, MO 63103-1424
Phone (314) 802-2647
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Provident Inc. | Psychiatric/Mental Health | Current | Accepting new patients |
Locations
2650 Olive St
Saint Louis, MO 63103
Phone (314) 371-6500
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1639796766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 OLIVE ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631031424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 OLIVE ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631031489",
"telephone_number": "314-533-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "COURTNEY",
"middle_name": "PAIGE",
"name_prefix": "Mrs.",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-06",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MO",
"license": "2020019958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COURTNEY",
"last_name": "SCHULT",
"middle_name": "PAIGE",
"prefix": "MISS",
"credential": "PMHNP-BC",
"code": "1",
"type": "Former Name"
}
]
}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 May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.