State of Missouri
NPI 1316991896ActiveOrganization· General Practice· Saint Charles, MO
General Practice in Saint Charles, 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. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1316991896 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | State of Missouri |
| NPI issued | May 20, 2006 |
| Last updated in NPPES | Oct 20, 2020 |
| Certified by provider | Oct 20, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Pediatrics | 208000000X | — | — |
| Urology | 208800000X | — | — |
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) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
Other General Practice providers in Saint Charles
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