Northwest MO Psychiatric Rehabilitation Center – Psychiatric Hospital, NPI 1104879444

Northwest MO Psychiatric Rehabilitation Center is a healthcare provider. based in Jefferson city, Missouri. specializing in Psychiatric Hospital. The organization holds a License No. EXEMPT (MO). The NPI Number for Northwest MO Psychiatric Rehabilitation Center is 1104879444

Main info

Organization
Name
Northwest MO Psychiatric Rehabilitation Center
NPI
1104879444
Phone
(573) 751-3398
Address
PO BOX 687
Authorized Official
MOLLY JANE BOECKMANN DIRECTOR OF ADMINISTRATIVE SERVICES
Enumeration Date
18 May 2006
Last Update Date
27 October 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Northwest MO Psychiatric Rehabilitation Center

  • PO BOX 687

    JEFFERSON CITY, MO 651020687

    Phone: (573) 751-3398

    Fax: (573) 526-4560

    Type: Mailing

  • Northwest Missouri Psychiatric Rehabilitation Center, 3505, Frederick Avenue, St. Joseph, Buchanan County, Missouri, 64506, United States

    SAINT JOSEPH, MO 645062914

    Phone: (816) 387-2300

    Fax: (816) 387-2329

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20071120000193OHospitalMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65102)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Northwest MO Psychiatric Rehabilitation Center?
Northwest MO Psychiatric Rehabilitation Center — NPI 1104879444 — is the standard way to identify this listing.
Does the file indicate Northwest MO Psychiatric Rehabilitation Center is practicing under active NPI?
Directory data currently reports Northwest MO Psychiatric Rehabilitation Center as active.
What is Northwest MO Psychiatric Rehabilitation Center's specialty?
The listing groups Northwest MO Psychiatric Rehabilitation Center with Psychiatric Hospital. Clinical services aligned with this taxonomy classification.
Where is Northwest MO Psychiatric Rehabilitation Center based?
Northwest MO Psychiatric Rehabilitation Center is tied to Jefferson City, Missouri in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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