| Meditelecare Of Missouri Llc | |
|
5661 Telegraph Rd Ste 4b Saint Louis MO 63129-4275 | |
| (860) 788-6404 | |
| Not Available |
| Full Name | Meditelecare Of Missouri Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5661 Telegraph Rd Ste 4b, Saint Louis, Missouri |
| Authorized Official Name and Position | Andrea Godfrey (CREDENTIALING & ENROLLMENT MANAGER) |
| Authorized Official Contact | 8603986441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meditelecare Of Missouri Llc Po Box 1595 Middletown CT 06457-8095 Ph: (860) 788-6404 | Meditelecare Of Missouri Llc 5661 Telegraph Rd Ste 4b Saint Louis MO 63129-4275 Ph: (860) 788-6404 |
| NPI Number | 1013416585 |
|---|---|
| Provider Enumeration Date | 02/09/2018 |
| Last Update Date | 05/05/2025 |
| Certification Date | 05/05/2025 |
| Medicare PECOS PAC ID | 2961764584 |
|---|---|
| Medicare Enrollment ID | O20180320001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013416585 | NPI | - | NPPES |
| Provider Name | Kimberly Souza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902200645 PECOS PAC ID: 3072735703 Enrollment ID: I20141113001809 |
| Provider Name | Angela Cain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720466246 PECOS PAC ID: 9436426822 Enrollment ID: I20170607000490 |
| Provider Name | Barbara Arnp Hignite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982617262 PECOS PAC ID: 1052398690 Enrollment ID: I20200626000864 |
| Provider Name | Cheryl A France |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134144215 PECOS PAC ID: 1557550175 Enrollment ID: I20200722002533 |
| Provider Name | Tracey Litwin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649532714 PECOS PAC ID: 9032366687 Enrollment ID: I20210106001570 |
| Provider Name | Omiana Ajibade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598124190 PECOS PAC ID: 4981992740 Enrollment ID: I20210803002428 |
| Provider Name | Amy Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851912257 PECOS PAC ID: 0840614657 Enrollment ID: I20220719000167 |
| Provider Name | Emily Drury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659889319 PECOS PAC ID: 5991041295 Enrollment ID: I20220824000297 |
| Provider Name | Rebecca Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871224139 PECOS PAC ID: 8325411630 Enrollment ID: I20230308000749 |
| Provider Name | Chioma Nwokoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134724982 PECOS PAC ID: 9335514926 Enrollment ID: I20230502001374 |
| Provider Name | Ijeoma Uchegbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336648625 PECOS PAC ID: 9638550155 Enrollment ID: I20230710000111 |
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