Active NPI
Susan Elizabeth O'Neill, PH.D.
- Clinical Psychologist
- Columbia, MO
National Provider Identifier
1972652238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2005038112
- Practice address
- 211 S 8TH St
Columbia, MO 65201-4868 - Phone
- (573) 882-4677
- Fax
- (573) 882-4583
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2005038112 | MO | Primary |
Addresses
Primary practice location
211 S 8TH St
Columbia, MO 65201-4868
Mailing address
PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 490086636 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUDOCREFERRAL@direct.health.missouri.edu | Direct | Curators of the University of Missouri |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005038112 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1972652238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 843966",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641843966",
"telephone_number": "573-884-3300",
"fax_number": "573-884-0943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S 8TH ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652014868",
"telephone_number": "573-882-4677",
"fax_number": "573-882-4583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2022-10-05",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2005038112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "490086636",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
"affiliation": "Y",
"endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
"affiliationName": "Curators of the University of Missouri",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "DIRECT",
"address_1": "1 Hospital Dr",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652120001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.