Organization Active NPI

Solace Care Network LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kirkwood, MO
National Provider Identifier
1699504449
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOLACE CARE NETWORK LLC
Practice address
1046 Geyer GRV
Kirkwood, MO 63122-5884
Phone
(314) 669-3075
Fax
(314) 696-6886
NPI assigned
Jul 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2024

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

Authorized official

Name
Mr. Jeffery Davis, DNP, FNP-BC, PMHNP
Title
President
Phone
(314) 669-3075

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1046 Geyer GRV
Kirkwood, MO 63122-5884

Mailing address

1046 Geyer GRV
Kirkwood, MO 63122-5884
Phone (618) 409-6448

Other names 2

  • Solace Care Doing business as
  • Solace Care Network Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1699504449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 GEYER GRV",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225884",
            "telephone_number": "618-409-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 GEYER GRV",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225884",
            "telephone_number": "314-669-3075",
            "fax_number": "314-696-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE CARE NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-669-3075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DNP, FNP-BC, PMHNP"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Solace Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Solace Care Network",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Solace Care Network",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; 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.