State of Missouri
NPI 1114971702ActiveOrganization· General Practice· Nevada, MO
General Practice in Nevada, Missouri, registered in NPPES in May 2006, part of State of Missouri. The authorized official on file is Molly Jane Boeckmann, Director Of Administrative Services.
Overview
| NPI | 1114971702 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | State of Missouri |
| NPI issued | May 19, 2006 |
| Last updated in NPPES | Aug 26, 2020 |
| Certified by provider | Aug 26, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other general practitioners in Nevada
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