KELLY N. BOTTERON MD – NPI #1013952860
Psychiatry & Neurology

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

KELLY BOTTERON is a psychiatry & neurologist located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1013952860 to KELLY BOTTERON on June 17, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2084P0804X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry

The NPI profile was previously updated about 5 years ago on Nov 15, 2021. 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 KELLY BOTTERON below.

NPI Profile for
KELLY N. BOTTERON

NPI Number
1013952860
Enumeration Date

(about 20 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
KELLY N. BOTTERON
Credentials
MD
Primary location
4444 FOREST PARK AVE
STE 2600
SAINT LOUIS, MO 63108-2212
Phone: (314) 286-1700 Fax: (314) 286-1777
Mailing address
4511 FOREST PARK AVE
STE 4300
SAINT LOUIS, MO 63108-2138
Phone: (314) 286-1700 Fax: (314) 408-2756
Sole Proprietor
No
Updated
Identifiers

Identifiers for KELLY BOTTERON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMO203692009
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
2084P0804X
- Psychiatry & Neurology / Child & Adolescent Psychiatry (Primary)
MO R3P75

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
Content Type
Affiliation
Y
Endpoint Location
4444 FOREST PARK AVE,
SAINT LOUIS, MO 77025-1669