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State of Missouri

Psychiatry Physician in Fulton, 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

1164477873

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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 600 E 5th St, Fulton, MO, 65251
Phone (573) 592-4100
Fax (573) 592-3000
Enumeration date May 23, 2006
Last updated in NPPES Aug 28, 2020

Taxonomy & classification

103T00000X Psychologist Behavioral Health & Social Service Providers Secondary
103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers Secondary
1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers Secondary
152W00000X Optometrist Eye and Vision Services Providers Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Primary
213E00000X Podiatrist Podiatric Medicine & Surgery Service Providers Secondary

Authorized official

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

Other identifiers

Identifier Type State Issuer
500490008 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

Who is the authorized official for State of Missouri?
NPPES lists Molly Boeckmann (Director of Administrative Services) as the authorized official for this organization.
What is the NPI number for State of Missouri?
The NPI for State of Missouri is 1164477873, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-28.