Paul Simon DO LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2007003913 Issued in MO

Legal business name

PAUL SIMON DO LLC

Practice address

255 Spencer Rd
Suite 201
Saint Peters, MO 63376-2494

Phone

(636) 939-2550

Fax

(636) 939-2551

NPI assigned

Dec 18, 2008

Last updated

Apr 23, 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

Kim Stelzer

Title

Assistant Director of Operations

Phone

(636) 939-2550

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1801032925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SPENCER RD",
            "address_2": "SUITE 201",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762494",
            "telephone_number": "636-939-2550",
            "fax_number": "636-939-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SPENCER RD",
            "address_2": "SUITE 201",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762494",
            "telephone_number": "636-939-2550",
            "fax_number": "636-939-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL SIMON DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "STELZER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "636-939-2550"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2007003913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801032925",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.