Individual provider Active NPI

Kelly Jo Kegerreis, MSW

  • Social Worker
  • Spokane, WA
National Provider Identifier
1063092682
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
60910901 Issued in WA
Practice address
1508 W 6TH Ave
Spokane, WA 99204-3409
Phone
(509) 624-5228
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 60910901 WA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 61297573 WA

Addresses

Primary practice location

1508 W 6TH Ave
Spokane, WA 99204-3409

Mailing address

812 S Walnut St
Spokane, WA 99204-3326
Phone (509) 624-3251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61297573WAMDAddiction (Substance Use Disorder) Counselor
60910901WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Addiction Recovery Centers Past Accepting new patients
Spokane Addiction Recovery Centers Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1063092682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S WALNUT ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043326",
            "telephone_number": "509-624-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 W 6TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043409",
            "telephone_number": "509-624-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGERREIS",
        "first_name": "KELLY JO",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "60910901",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "61297573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.