Active NPI
State of Missouri
Doing business as Metropolitan St. Louis Psychiatric Center
- Psychiatric Hospital
- Saint Louis, MO
National Provider Identifier
1821043589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- Legal business name
- STATE OF MISSOURI
- Doing business as
- Metropolitan St. Louis Psychiatric Center
- Practice address
- 5351 Delmar Blvd
Saint Louis, MO 63112-3146 - Phone
- (314) 877-0500
- Fax
- (314) 877-0553
- NPI assigned
- May 23, 2006
- Last updated
- Oct 27, 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
5351 Delmar Blvd
Saint Louis, MO 63112-3146
Mailing address
1706 E Elm St
Jefferson City, MO 65101-4130
Phone (573) 751-3398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020565701 | Medicaid | MO |
Other names 1
- Metropolitan St. Louis Psychiatric Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1821043589. Details of each certification follow.
Hospital certification: CCN 264025
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- METROPOLITAN ST LOUIS PSYCHIATRIC CTR
- Certification status
- Terminated Voluntary: merger or closure, Dec 1, 2020
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Apr 29, 1991
- Last certification
- Jan 25, 2018
- Beds
- 125 (100 certified)
- Ownership / control type
- State
- Facility address
- 5351 Delmar Boulevard
Saint Louis, MO 63112
National Provider Directory
National Provider Directory- Part of
- Missouri Tuberculosis Lab
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Nevada Habilitation Center
- General Practice Physician
- Nevada, MO
- NPI 1114971702
Member Of
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": "1603756800000",
"number": "1821043589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 E ELM ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651014130",
"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": "5351 DELMAR BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631123146",
"telephone_number": "314-877-0500",
"fax_number": "314-877-0553"
}
],
"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": "2020-10-27",
"certification_date": "2020-10-27",
"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": "020565701",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Metropolitan St. Louis Psychiatric Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Metropolitan St. Louis Psychiatric Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Saint Louis, MO
- State of Missouri (Metropolitan SL PC Pharmcy)
- State of Missouri (St Louis Regional Center)
- State of Missouri (Bellefontaine Habilitation Center)
- State of Missouri (Bellefontaine Habilitation Center)
- State of Missouri (Bellefontaine Habilitaion Center-Waiver Services)
- State of Missouri (St. Louis Developmental Disabilities Treatment Center ISL)
- State of Missouri Department of Mental Health (St Louis Forensic Treatment Center)
- Jennifer Stateler, P.T.
- Stephen Francis Staten, MD
- James H States, ACNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.