CASEY VICKSTROM MD, PHD – NPI #1154053411
Psychiatry & Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CASEY VICKSTROM is a psychiatry & neurologist located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1154053411 to CASEY VICKSTROM on June 27, 2022. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2084N0400X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Neurology

The NPI profile was last updated on Jul 16, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CASEY VICKSTROM below.

NPI Profile for
CASEY VICKSTROM

NPI Number
1154053411
Enumeration Date

(about 4 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
CASEY VICKSTROM
Credentials
MD, PHD
Primary location
1 CHILDRENS PL STE 3S34
SAINT LOUIS, MO 63110-1002
Phone: (314) 454-6006 Fax:
Mailing address
Same as primary location
Sole Proprietor
No
Updated
Certification Date
Jul 16, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084N0400X
- Psychiatry & Neurology / Neurology (Primary)
MO 2023040873

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
BJC
Content Type
CSV
Affiliation
N
Endpoint Location
1 CHILDRENS PL STE 3S34,
SAINT LOUIS, MO 77025-1669