Active NPI
Gateway Psychiatric Group, LLC
- Community/Behavioral Health Agency
- Saint Louis, MO
National Provider Identifier
1891028411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- GATEWAY PSYCHIATRIC GROUP, LLC
- Practice address
- 11710 Old Ballas Rd
Suite 110
Saint Louis, MO 63141-7076 - Phone
- (314) 567-1958
- NPI assigned
- Sep 14, 2009
- Last updated
- Apr 18, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lee Burlison
- Title
- Office Manager
- Phone
- (314) 567-1958
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | NU | Primary |
Addresses
Primary practice location
11710 Old Ballas Rd
Suite 110
Saint Louis, MO 63141-7076
Mailing address
11710 Old Ballas Rd
Suite 110
Saint Louis, MO 63141-7076
Phone (314) 567-1958
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Psychiatry Physician
- Saint Louis, MO
- NPI 1245342161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1366243200000",
"number": "1891028411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11710 OLD BALLAS RD",
"address_2": "SUITE 110",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417076",
"telephone_number": "314-567-1958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11710 OLD BALLAS RD",
"address_2": "SUITE 110",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417076",
"telephone_number": "314-567-1958"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GATEWAY PSYCHIATRIC GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-09-14",
"last_updated": "2013-04-18",
"status": "A",
"authorized_official_last_name": "BURLISON",
"authorized_official_first_name": "LEE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "314-567-1958"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
- Gateway Iom, LLC
- Gateway Low Vision LLC
- Gateway Mental Wellness (Gateway Life Counseling)
- Gateway Nephrology Corp
- Gateway Optical Service Inc.
- Gateway Regenerative Medicine, LLC
- Gateway Region Young Men's Christian Association
- Gateway RX LLC (Uvanta Pharmacy - St. Louis)
- Gateway RX, LLC
- Gateway Spine, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.