Matthew Stewart Wilson (NPI# 1649392796, PAC ID# 9830277573) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1649392796 |
| PAC ID by PECOS | 9830277573 |
| Professional Enrollment ID | I20080422000525 |
| Full Name | Matthew Stewart Wilson |
| Organization Legal Name | MERCY CLINIC ADULT PSYCHIATRY LLC |
| Address |
12125 Conway Suite 160 St. Louis MO 63141 |
| Phone Number | 3142512870 |
| Gender | M |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 4688998602 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260020 | MERCY HOSPITAL ST LOUIS |
| Address | Phone | Organization |
|---|---|---|
| 12125 Conway, Suite 160, St. Louis, MO 63141 | 3142512870 | MERCY CLINIC ADULT PSYCHIATRY LLC |
| Organization Legal Name | MERCY CLINIC ADULT PSYCHIATRY LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Enos Moss | Nurse Practitioner | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Erum Qazi | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 1400 Us Hwy 61, Suite 150a, Festus, MO 63028-4100 |
| Michael P Cooper | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 1400 Us Hwy 61, Suite 150a, Festus, MO 63028-4100 |
| Erica Chick | Clinical Social Worker | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Thomas Horn | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Tianyuan Yin Cornell | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Street Address |
12125 CONWAY SUITE 160 |
| City | ST. LOUIS |
| State | MO |
| Zip | 63141 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Enos Moss | Nurse Practitioner | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Erica Chick | Clinical Social Worker | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Thomas Horn | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Tianyuan Yin Cornell | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Finnerty | Nurse Practitioner | Associated Physicians Group Ltd | 845 N New Ballas Court, Suite 120, Creve Couer, MO 63141 |
| Patricia L Tracy | Physical Therapy | Associated Physicians Group, Ltd | 845 N New Ballas Court, Creve Couer, MO 63141 |
| Kevin O Easley | Gynecological Oncology | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Kelly L Ball | Nurse Practitioner | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Amy Kelly Neu | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Theresa A Roche | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Kathleen A Taggart | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Angela C Cook | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Christina M Bardle | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Lisa M Brazil | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Find all physicians in zip 63141 | |||
| City | ST. LOUIS |
| Zip Code | 63141 |
| Specialty | PSYCHIATRY |
| City + Specialty | ST. LOUIS + PSYCHIATRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.