Active NPI
Schuyler Cole Metlis, M.D.
- Plastic Surgery Physician
- Hannibal, MO
National Provider Identifier
1679546949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 2008030672
- Practice address
- 6500 Hospital Dr
Hannibal, MO 63401-6890 - Phone
- (573) 629-3500
- Fax
- (573) 629-3515
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 2008030672 | MO | Primary |
| Plastic Surgery Physician | 208200000X | 036.126436 | IL |
Addresses
Primary practice location
6500 Hospital Dr
Hannibal, MO 63401-6890
Mailing address
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 629-3500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 039494700 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.126436 | IL | MD | Plastic Surgery Physician |
| 2008030672 | MO | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295568000000",
"number": "1679546949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 HOSPITAL DR",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016890",
"telephone_number": "573-629-3500",
"fax_number": "573-629-3515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 HOSPITAL DR",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016890",
"telephone_number": "573-629-3500",
"fax_number": "573-629-3515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METLIS",
"first_name": "SCHUYLER",
"middle_name": "COLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2011-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MO",
"license": "2008030672",
"primary": true
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "IL",
"license": "036.126436",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "039494700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hannibal, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.