Active NPI
Roger Louis Gennari, PHD CLINICAL PSYCHOL
- Psychologist
- Clayton, MI
National Provider Identifier
1992878847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- R0043
- Practice address
- 225 South Meramec
Suite 432T
Clayton, MI 63105 - Phone
- (314) 721-4975
- Fax
- (314) 721-6778
- NPI assigned
- Nov 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | R0043 | MO | Primary |
Addresses
Primary practice location
225 South Meramec
Suite 432T
Clayton, MI 63105
Mailing address
225 South Meramec
Suite 432T
Clayton, MI 63105
Phone (314) 721-4975
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0043 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992878847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 SOUTH MERAMEC",
"address_2": "SUITE 432T",
"city": "CLAYTON",
"state": "MI",
"postal_code": "63105",
"telephone_number": "314-721-4975",
"fax_number": "314-721-6778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 SOUTH MERAMEC",
"address_2": "SUITE 432T",
"city": "CLAYTON",
"state": "MI",
"postal_code": "63105",
"telephone_number": "314-721-4975",
"fax_number": "314-721-6778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENNARI",
"first_name": "ROGER",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "PHD CLINICAL PSYCHOL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "R0043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clayton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.