Organization Active NPI

CM Kinney and Associates, LLC

  • Clinical Social Worker
  • Manchester, MO
National Provider Identifier
1033734702
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CM KINNEY AND ASSOCIATES, LLC
Practice address
623 Meramec Station Rd
Manchester, MO 63021-5550
Phone
(314) 266-9131
NPI assigned
Jun 9, 2020
Last updated
Apr 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Victoria Shepherd
Title
Admim
Phone
(314) 315-5148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

623 Meramec Station Rd
Manchester, MO 63021-5550

Mailing address

1237 Warson Woods Dr
Saint Louis, MO 63122-1735
Phone (314) 608-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200729000997 MO Part B Supplier - Clinic/Group Practice 4688099328 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1033734702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 WARSON WOODS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631221735",
            "telephone_number": "314-608-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 MERAMEC STATION RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215550",
            "telephone_number": "314-266-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CM KINNEY AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2022-04-22",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "ADMIM",
        "authorized_official_telephone_number": "314-315-5148"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.