Executive Neuropsychiatric Systems Incorporated

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD102146 Issued in MO

Legal business name

EXECUTIVE NEUROPSYCHIATRIC SYSTEMS INCORPORATED

Practice address

225 S Meramec Ave
Suite 1221T
Clayton, MO 63105-3511

Phone

(314) 367-3050

Fax

(314) 367-3712

NPI assigned

Dec 16, 2008

Last updated

Jul 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Annette Minchin, M.D.

Title

President

Phone

(314) 367-3050

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sherry Doney, PMHCNS-BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Saint Louis, MO
  • NPI 1982634168
  NPD (past)
• Timothy Jenkins, LCSW

  • Clinical Social Worker
  • Wentzville, MO
  • NPI 1902967789
  NPD (past)
• Peggy A Szwabo, PHD, MSW, RN

  • Clinical Social Worker
  • Saint Louis, MO
  • NPI 1902944259
  NPD (past)

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1790920023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "SUITE 1221T",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053511",
            "telephone_number": "314-367-3050",
            "fax_number": "314-367-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "SUITE 1221T",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053511",
            "telephone_number": "314-367-3050",
            "fax_number": "314-367-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE NEUROPSYCHIATRIC SYSTEMS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "MINCHIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-367-3050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "MD102146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFICATION NUMBER",
            "identifier": "000095333",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH IDENTIFICATION NUMBER",
            "identifier": "10853441",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Clayton, MO
• Providers in Clayton, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.