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State of Missouri

General Practice Physician in Nevada, MO · enumerated 2006 · authorized official Molly Boeckmann, Director of Administrative Services.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1114971702

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Registry record

Entity type Organization (Type 2)
Legal business name State of Missouri
Other name <Unavail>
Parent organization State of Missouri
Practice address 2323 N Ash St, Nevada, MO, 64772
Phone (417) 667-7833
Fax (417) 448-1138
Enumeration date May 19, 2006
Last updated in NPPES Aug 26, 2020

Taxonomy & classification

2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Secondary
208D00000X General Practice Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Molly Boeckmann
Title Director of Administrative Services
Phone (573) 751-4055

Other identifiers

Identifier Type State Issuer
501499917 Medicaid MO -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for State of Missouri?
The NPI for State of Missouri is 1114971702, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for State of Missouri?
NPPES lists Molly Boeckmann (Director of Administrative Services) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-26.