Neuroregenesis, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2007006356 Issued in MO

Legal business name

NEUROREGENESIS, P.C.

Practice address

1176 Town and Country Commons
Chesterfield, MO 63017-8200

Phone

(636) 893-1137

Fax

(636) 893-1101

NPI assigned

Apr 25, 2010

Last updated

Aug 21, 2014By 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

Dr. Robert Andrew Gillespie, PH.D.NPI 1356360036

Title

Psychologist

Phone

(610) 996-1200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Robert Andrew Gillespie, PH.D.

  • Clinical Psychologist
  • Chesterfield, MO
  • NPI 1356360036
  Authorized official Same address or phone

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

{
    "created_epoch": "1272153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1851618284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 TOWN AND COUNTRY COMMONS",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178200",
            "telephone_number": "610-996-1200",
            "fax_number": "636-893-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 TOWN AND COUNTRY COMMONS",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178200",
            "telephone_number": "636-893-1137",
            "fax_number": "636-893-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROREGENESIS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-25",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "GILLESPIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "610-996-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2007006356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.