NPIMap

Organization Active NPI

Capital Region Medical Center

Doing business as Center for Mental Wellness

  • Geriatric Psychiatry Physician
  • Jefferson City, MO
National Provider Identifier
1801079553
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
Legal business name
CAPITAL REGION MEDICAL CENTER
Doing business as
Center for Mental Wellness
Practice address
1432 Southwest Blvd
Jefferson City, MO 65109-2444
Phone
(573) 632-5560
Fax
(573) 632-5875
NPI assigned
Dec 17, 2007
Last updated
Dec 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Authorized official

Name
James R McMillan
Title
VP-Finance
Phone
(573) 632-5100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Psychologist 103T00000X NU
Geriatric Psychiatry Physician 2084P0805X NU Primary

Addresses

Primary practice location

1432 Southwest Blvd
Jefferson City, MO 65109-2444

Mailing address

PO Box 1128
Jefferson City, MO 65102-1128
Phone (573) 632-5560

Other names 1

  • Center for Mental Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Region Medical Center47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1801079553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021128",
            "telephone_number": "573-632-5560",
            "fax_number": "573-632-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 SOUTHWEST BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092444",
            "telephone_number": "573-632-5560",
            "fax_number": "573-632-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP-FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.