Moniteau Mental Health Care

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

2000161947 Issued in MO

Legal business name

MONITEAU MENTAL HEALTH CARE

Practice address

320 S Oak St
California, MO 65018-1824

Phone

(573) 230-1037

NPI assigned

Jul 17, 2008

Organization subpart

No

Name

Mrs. Kellie L Shuck, APRN-PMHNPI 1598720534

Title

Owner

Phone

(573) 796-2905

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellie L Shuck, PMHNP-CNS, BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Patten, ME
  • NPI 1598720534

  Psychiatric/Mental Health

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2008.

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1780848747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5111",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658015111",
            "telephone_number": "417-429-2180",
            "fax_number": "417-832-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S OAK ST",
            "city": "CALIFORNIA",
            "state": "MO",
            "postal_code": "650181824",
            "telephone_number": "573-230-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONITEAU MENTAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "SHUCK",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-796-2905",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN-PMH"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2000161947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427531801",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moniteau County Health Center
• Moniteau County R-I School
• Moniteau County SB 40 Board
• Moniteau County Senate Bill 40 Board
• Moniteau County Senate Bill 40 Board
• N & R of California West, LLC
• N & R of California, Inc.
• Michelle Ann Nolph, ANP
• Pamida Stores Operating Co LLC
• Pamida Stores Operating Co LLC

• All providers in California, MO
• Psychiatric/Mental Health Clinical Nurse Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.