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Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

State of Missouri

Physical Medicine & Rehabilitation Physician in Saint Louis, 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

1710931167

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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 10695 Bellefontaine Rd, Saint Louis, MO, 63137
Phone (314) 340-6000
Fax (314) 340-6199
Enumeration date May 20, 2006
Last updated in NPPES Oct 27, 2020

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Secondary
208100000X Physical Medicine & Rehabilitation 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
501500102 Medicaid MO -
CG4952 Other MO MEDICARE RAILROAD

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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-10-27. Verify at npiregistry.cms.hhs.gov.
Where is State of Missouri located?
The practice location on file with NPPES is in Saint Louis, MO.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-10-27.