STATE OF MISSOURI (NPI# 1609954809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609954809 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSOURI |
| Other Organization Name | PASEO CLINIC |
| Practice Address |
1000 E 24th St Kansas City MO 64108-2776 |
| Mailing Address |
Po Box 687 Jefferson City MO 65102-0687 |
| Practice Telephone | 8165127143 |
| Mailing Telephone | 5737513398 |
| Mailing Fax Number | 5735264560 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Telephone | 5737514055 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSOURI |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
EXEMPT | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 866205800 | 05 |
| Other Name | Type Code |
|---|---|
| Paseo Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781499 | State of Missouri | Rehabilitation Counselor | 3418 Knipp Dr, Jefferson City, MO 65109-5701 | 2020-02-07 |
| 1275073280 | State of Missouri | General Practice | 1547 W Commerce Drive, Marshall, MO 65340-3907 | 2017-02-24 |
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1386843621 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15555 Little Blue Rd, Kansas City, MO 64139 | 2007-07-17 |
| 1922207679 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5410 Rinker Rd, Kansas City, MO 64129-2308 | 2007-07-13 |
| 1760681415 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1501 N River Blvd, Independence, MO 64050-1760 | 2007-07-13 |
| 1164630463 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 11 Brady Cir, Overland, MO 63114-1110 | 2007-05-18 |
| 1548322605 | State of Missouri | Day Training, Developmentally Disabled Services | 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 | 2006-12-15 |
| 1366503153 | State of Missouri | Day Training, Developmentally Disabled Services | 471 E Slater St, Marshall, MO 65340 | 2006-12-13 |
| 1427118033 | State of Missouri | Day Training, Developmentally Disabled Services | 522 Star St, Marshall, MO 65340 | 2006-12-12 |
| Street Address |
1000 E 24TH ST |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64108-2776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962404764 | Brad E Cochren | Pharmacist | 1000 E 24th St, Kansas City, MO 64108-2776 | 2005-08-11 |
| 1558970988 | John Tucker | Nurse Practitioner | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-07-31 |
| 1538784871 | Taye L Conkle | Registered Nurse | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-06-12 |
| 1801415757 | Zachary Michael Bartochowski | Student in an Organized Health Care Education/Training Program | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-04-10 |
| 1578192795 | Hirsch Srivastava | Psychiatry & Neurology | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-04-08 |
| 1881223709 | Ferdinand Osayande | Student in an Organized Health Care Education/Training Program | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-04-02 |
| 1053940007 | Anisha Rao Chinthalapally | Student in an Organized Health Care Education/Training Program | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-04-02 |
| 1386273415 | Valeriy Zvonarev | Student in an Organized Health Care Education/Training Program | 1000 E 24th St, Kansas City, MO 64108-2776 | 2020-04-01 |
| 1184266157 | Linda Carrol Skaggs-kimbrough | Counselor | 1000 E 24th St, Kansas City, MO 64108-2776 | 2019-10-11 |
| 1366090177 | Margaret Belding Watson | Social Worker | 1000 E 24th St, Kansas City, MO 64108-2776 | 2019-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345561 | Diversity Telehealth, LLC | Health Educator | 1601 East 18th Street, 320a, Kansas City, MO 64108 | 2020-04-25 |
| 1447894092 | Claire-louise Sophia Young | Student in an Organized Health Care Education/Training Program | Truman Medical Center - Department of Pathology, 2301 Holmes, Kansas City, MO 64108 | 2019-11-06 |
| 1053962415 | Kymberly Kline | Behavior Technician | Riley Aba & Autism Center, 1936 Summit St, Kansas City, MO 64108 | 2019-09-26 |
| 1841854643 | Mallak Ahmed Ghozlan Zatreh | Student in an Organized Health Care Education/Training Program | 2301 Homes Street, Kansas City, MO 64108 | 2019-04-26 |
| 1003470881 | Sindhuja Palle | Internal Medicine | Truman Medial Center, 2301 Holmes Dept. of Interal Medicine, Kansas City, MO 64108 | 2019-04-26 |
| 1467016253 | Osama Mahmoud Okasha | Internal Medicine | Truman Medicial Center, 2301 Holmes, Dept of Internal Medicine, Kansas City, MO 64108 | 2019-04-26 |
| 1730643719 | Michele D Smith | Registered Nurse | 2101 Charlotte Street, Urology, Kansas City, MO 64108 | 2019-01-24 |
| 1437640414 | Omar Fayez Ahmad Abuqamar | Student in an Organized Health Care Education/Training Program | Truman Medical Center, 2301 Holmes St., Dept. of Internal Medicine, Kansas City, MO 64108 | 2018-05-24 |
| 1992200190 | Hannah Rebekah Hurst | Student in an Organized Health Care Education/Training Program | 2101 Charlotte St Ste 200, Kansas City, MO 64108 | 2018-03-28 |
| 1659873404 | William Andrew Carroll | Chiropractor | 313 E. 17th St. #210, Kansas City, MO 64108 | 2018-03-07 |
| Find all providers in zip 64108 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942501143 | Swope Health Services | Clinic/Center | 3950 E 51st St, Kansas City, MO 64130-3081 | 2010-11-04 |
| 1932412186 | Comprehensive Mental Health Services, Inc/renaisance West | Clinic/Center | 5840 Swope Pkwy, Kansas City, MO 64130-4262 | 2010-07-16 |
| 1043536626 | Kansas City Community Center | Clinic/Center | 622 Benton Blvd, Kansas City, MO 64124-2559 | 2010-04-08 |
| 1952532202 | The Human Enhancement Learning Program of Servants Inc. | Clinic/Center | 400 N 6th St, Kansas City, KS 66101-3135 | 2009-08-05 |
| 1225166432 | Tri-county Mental Health Services, Inc. | Clinic/Center | 1505 Ne Parvin Rd Ste D, Kansas City, MO 64116-2381 | 2007-03-01 |
| 1891872420 | Northland Family Counseling Center, Inc. | Clinic/Center | 429 N.e. 69 Highway, Kansas City, MO 64119-3118 | 2006-11-01 |
| 1013459908 | Swope Health Services | Clinic/Center | 3801 Blue Pkwy, Kansas City, MO 64130-2807 | 2016-11-09 |
| 1720438302 | Truman Medical Center, Incorporated | Clinic/Center | 300 W 19th Ter, Kansas City, MO 64108-2026 | 2016-06-15 |
| 1598110116 | Tri-county Mental Health Services, Inc. | Clinic/Center | 3100 Ne 83rd St, Suite 1001, Kansas City, MO 64119-4400 | 2016-05-02 |
| 1023462058 | Heartland Center for Behavioral Change | Clinic/Center | 1730 Prospect Ave, Kansas City, MO 64127-2544 | 2016-04-15 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64108 |
Please comment or provide details below to improve the information on STATE OF MISSOURI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.