Active NPI
State of Missouri
Doing business as Center for Behavioral Medicine
- Psychiatric Hospital
- Kansas City, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- Legal business name
- STATE OF MISSOURI
- Doing business as
- Center for Behavioral Medicine
- Practice address
- 1000 E 24TH St
Kansas City, MO 64108-2776 - Phone
- (816) 512-7000
- Fax
- (816) 512-7509
- NPI assigned
- May 23, 2006
- Last updated
- Aug 26, 2020
- Organization subpart
- Yes
- Parent organization
- STATE OF MISSOURI
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Molly Jane Boeckmann
- Title
- Director of Administrative Services
- Phone
- (573) 751-4055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | Primary |
Addresses
Primary practice location
1000 E 24TH St
Kansas City, MO 64108-2776
Mailing address
PO Box 687
1706 E Elm St
Jefferson City, MO 65102-0687
Phone (573) 751-3398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020931705 | Medicaid | MO |
Other names 1
- Center for Behavioral Medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071029000275 | MO | Part A Provider - Hospital | 1456254226 | Practice locations: Kansas City, MO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1730134495. Details of each certification follow.
Hospital certification: CCN 264008
- Legal name
- STATE OF MISSOURI
- Doing business as
- CENTER FOR BEHAVIORAL MEDICINE
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Jul 1, 1966
- Last certification
- Mar 7, 2013
- Beds
- 160 (110 certified)
- Ownership / control type
- State
- Organization structure
- Government
- Enrollment address
- 1000 E 24TH St
Kansas City, MO 64108-2776 - Hospital subgroups
- Psychiatric
Other NPIs with the same Medicare PAC ID 11
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Hawthorn Children's Psychiatric Hosptial
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1033289897
1456254226
-
dba Fulton State Hospital
- Psychiatric Hospital
- Fulton, MO
- NPI 1104878792
1456254226
-
dba Northwest MO Psychiatric Rehabilitation Center
- Psychiatric Hospital
- Saint Joseph, MO
- NPI 1104879444
1456254226
-
dba Fulton State Hospital
- Psychiatry Physician
- Fulton, MO
- NPI 1164477873
1456254226
-
dba St. Louis Developmental Disabilities Treatment Center
- General Practice Physician
- Saint Charles, MO
- NPI 1316991896
1456254226
-
dba St Louis Forensic Treatment Center
- Psychiatry Physician
- Saint Louis, MO
- NPI 1427002013
1456254226
-
dba Southeast MO Mental Health Center
- Psychiatry Physician
- Farmington, MO
- NPI 1437106705
1456254226
-
dba Center for Behavioral Health
- Psychiatry Physician
- Kansas City, MO
- NPI 1497709083
1456254226
-
dba St Louis Forensic Treatment Center
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1578518239
1456254226
-
dba Bellefontaine Habilitation Center
- Physical Medicine & Rehabilitation Physician
- Saint Louis, MO
- NPI 1710931167
1456254226
-
dba Southeast MO Mental Health Center
- Psychiatric Hospital
- Farmington, MO
- NPI 1861447526
1456254226
Care Compare: Hospital
Medicare Care Compare- Listed as
- Center for Behavioral Medicine
- Type
- Psychiatric
- Ownership
- Government - State
- Medicare certification status
- Active
- Emergency services
- No
National Provider Directory
National Provider Directory- Tax ID family
- Missouri Tuberculosis Lab
- Part of
- Missouri Tuberculosis Lab
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Southeast Missouri Residential Services-Sikeston
- Intellectual Disabilities Intermediate Care Facility
- Sikeston, MO
- NPI 1598844029
-
dba Southeast Missouri Residential Services ISL
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Poplar Bluff, MO
- NPI 1598906372
-
dba Center for Behavioral Health
- Case Management Agency
- Kansas City, MO
- NPI 1609087584
-
dba Paseo Clinic
- Substance Use Disorder Rehabilitation Clinic/Center
- Kansas City, MO
- NPI 1609954809
-
dba Metropolitan SL PC Pharmcy
- Long Term Care Pharmacy
- Saint Louis, MO
- NPI 1619016862
-
dba Southeast Missouri Mental Health Center Pharmacy
- Institutional Pharmacy
- Farmington, MO
- NPI 1669511093
-
dba Southeast Missouri Mental Health Center
- Case Management Agency
- Farmington, MO
- NPI 1669683439
-
dba Higginsville Habilitation Center
- Intellectual Disabilities Intermediate Care Facility
- Higginsville, MO
- NPI 1689745010
-
dba St Louis Regional Center
- Developmentally Disabled Services Day Training Agency
- Saint Louis, MO
- NPI 1710053780
-
dba Bellefontaine Habilitation Center
- Physical Medicine & Rehabilitation Physician
- Saint Louis, MO
- NPI 1710931167
-
dba Higginsville ISL II
- Developmentally Disabled Services Day Training Agency
- Higginsville, MO
- NPI 1720140148
Ownership & related parties
All disclosed owners & managing parties 8
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jeanette M Simmons | W-2 Managing Employee | Aug 1, 2014 | |
| Molly Boeckmann | Corporate Director | Jul 1, 2020 | |
| W-2 Managing Employee | Jul 1, 2020 | ||
| State of Missouri | 5% Or Greater Direct Ownership Interest | Jul 1, 1966 | 100% |
| Nashaat N Boutros | W-2 Managing Employee | Feb 24, 2014 | |
| Tyler Rinehart | W-2 Managing Employee | Jul 1, 2019 | |
| Gloria Gehlert | W-2 Managing Employee | Apr 1, 2016 | |
| Becky D Norbury | W-2 Managing Employee | Feb 1, 2012 | |
| Donna S Siebeneck | W-2 Managing Employee | Oct 1, 2014 |
Owners & managing parties with NPI records 12
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Clinical Psychologist
- Saint Joseph, MO
- NPI 1457458432
W-2 Managing Employee
-
dba Hawthorn Children's Psychiatric Hosptial
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1033289897
5% Or Greater Direct Ownership Interest
-
dba Fulton State Hospital
- Psychiatric Hospital
- Fulton, MO
- NPI 1104878792
5% Or Greater Direct Ownership Interest
-
dba Northwest MO Psychiatric Rehabilitation Center
- Psychiatric Hospital
- Saint Joseph, MO
- NPI 1104879444
5% Or Greater Direct Ownership Interest
-
dba Fulton State Hospital
- Psychiatry Physician
- Fulton, MO
- NPI 1164477873
5% Or Greater Direct Ownership Interest
-
dba St. Louis Developmental Disabilities Treatment Center
- General Practice Physician
- Saint Charles, MO
- NPI 1316991896
5% Or Greater Direct Ownership Interest
-
dba St Louis Forensic Treatment Center
- Psychiatry Physician
- Saint Louis, MO
- NPI 1427002013
5% Or Greater Direct Ownership Interest
-
dba Southeast MO Mental Health Center
- Psychiatry Physician
- Farmington, MO
- NPI 1437106705
5% Or Greater Direct Ownership Interest
-
dba Center for Behavioral Health
- Psychiatry Physician
- Kansas City, MO
- NPI 1497709083
5% Or Greater Direct Ownership Interest
-
dba St Louis Forensic Treatment Center
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1578518239
5% Or Greater Direct Ownership Interest
-
dba Bellefontaine Habilitation Center
- Physical Medicine & Rehabilitation Physician
- Saint Louis, MO
- NPI 1710931167
5% Or Greater Direct Ownership Interest
-
dba Southeast MO Mental Health Center
- Psychiatric Hospital
- Farmington, MO
- NPI 1861447526
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 5
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| St Louis Forensic Treatment Center | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Southeast Missouri Mental Health Center | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Fulton State Hospital | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Northwest Missouri Psychiatric Rehabilitation Center | Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 1966 Jan 1, 1966 |
| Hawthorn Children's Psychiatric Hospital | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1981 |
Owned or controlled facilities with NPI records 5
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Hawthorn Children's Psychiatric Hosptial
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1033289897
5% Or Greater Direct Ownership Interest
-
dba Fulton State Hospital
- Psychiatric Hospital
- Fulton, MO
- NPI 1104878792
5% Or Greater Direct Ownership Interest
-
dba Northwest MO Psychiatric Rehabilitation Center
- Psychiatric Hospital
- Saint Joseph, MO
- NPI 1104879444
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba St Louis Forensic Treatment Center
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1578518239
5% Or Greater Direct Ownership Interest
-
dba Southeast MO Mental Health Center
- Psychiatric Hospital
- Farmington, MO
- NPI 1861447526
5% Or Greater Direct Ownership Interest
Facilities with the same owner 5
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Hawthorn Children's Psychiatric Hosptial
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1033289897
State of Missouri
-
dba Fulton State Hospital
- Psychiatric Hospital
- Fulton, MO
- NPI 1104878792
State of Missouri
-
dba Northwest MO Psychiatric Rehabilitation Center
- Psychiatric Hospital
- Saint Joseph, MO
- NPI 1104879444
State of Missouri
-
dba St Louis Forensic Treatment Center
- Psychiatric Hospital
- Saint Louis, MO
- NPI 1578518239
State of Missouri
-
dba Southeast MO Mental Health Center
- Psychiatric Hospital
- Farmington, MO
- NPI 1861447526
State of Missouri
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598400000000",
"number": "1730134495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 687",
"address_2": "1706 E ELM ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651020687",
"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": "1000 E 24TH ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641082776",
"telephone_number": "816-512-7000",
"fax_number": "816-512-7509"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF MISSOURI",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "STATE OF MISSOURI",
"enumeration_date": "2006-05-23",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"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": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020931705",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Center for Behavioral Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Center for Behavioral Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kansas City, MO
- State of Missouri (Developmental Disabilities Behavior Services)
- State of Missouri (Lakeland Group Home)
- State of Missouri (Center for Behavioral Health)
- State of Missouri (Center for Behavioral Health)
- State of Missouri (Paseo Clinic)
- State of Missouri (Center for Behavioral Medicine)
- State of Missouri (Esperanza Group Home)
- Angela Stathopoulos
- Regina Staves, LPC
- Stay at Home Solutions
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.