FULTON STATE HOSPITAL
NPI 1164477873
Psychiatry & Neurology - Psychiatry in Fulton, MO
About Fulton State Hospital NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FULTON STATE HOSPITAL (NPI 1164477873) is a healthcare organization registered as a psychiatry in Fulton, Missouri and active in the NPI registry since May 2006. The organization lists Molly Jane Boeckmann, Director Of Administrative Services, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 8
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fulton State Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
39Medicare enrollment records show 39 clinicians reassign Medicare billing to Fulton State Hospital, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 9 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 7
Nearest to this location (20)
See all 39Fulton, MO 65251
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is State Of Missouri's NPI number?
The NPI number for State Of Missouri is 1164477873. It was assigned to this organization in the NPPES registry on May 23, 2006. The provider is doing business as Fulton State Hospital.
Where is State Of Missouri located?
State Of Missouri is located at 600 E 5th St, Fulton, MO 65251. The listed phone number is (573) 592-4100.
What is State Of Missouri's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is State Of Missouri enrolled in Medicare?
Yes. State Of Missouri is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through State Of Missouri?
According to the CMS Revalidation Reassignment List (October 2026 release), 39 clinicians in 7 Medicare specialties reassign their Medicare billing to State Of Missouri. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Psychiatry (20), Nurse Practitioner (9) and Clinical Psychologist (6). Of these, 8 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for State Of Missouri was last updated on August 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Fulton State Hospital · NPI 1164477873
Psychiatry organization in Fulton, Missouri. Organization record, active in the CMS NPPES registry since May 23, 2006.
## Identity
- **NPI:** 1164477873 (Entity type: Organization)
- **Enumerated:** May 23, 2006
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **Legal business name:** State Of Missouri
- **Organization subpart:** Yes (part of State Of Missouri)
- **Authorized official:** Molly Boeckmann, DIRECTOR OF ADMINISTRATIVE SERVICES
## Practice location
- **Address:** 600 E 5TH ST, Fulton, MO 65251-1753
- **Phone:** (573) 592-4100 · **Fax:** (573) 592-3000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 39 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Psychiatry (20), Nurse Practitioner (9), Clinical Psychologist (6); 8 practice at this address and 9 within 10 miles; [full list](https://npiprofile.com/npi/1164477873/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 28, 2020
- **Other identifiers:** Medicaid 500490008 (MO)
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Source: [NPI Profile](https://npiprofile.com/npi/1164477873) · Data from the CMS NPPES public registry.