Active NPI
Kimberly Anne Salls, MA
- Behavior Analyst
- Saint Louis, MO
National Provider Identifier
1114102365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-04-1947
- Practice address
- 5389 Arsenal St
Saint Louis, MO 63139-1401 - Phone
- (314) 772-6933
- Fax
- (314) 772-5858
- NPI assigned
- Jan 7, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-04-1947 | MO | Primary |
Addresses
Primary practice location
5389 Arsenal St
Saint Louis, MO 63139-1401
Mailing address
5389 Arsenal St
Saint Louis, MO 63139-1401
Phone (314) 772-6933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 856074703 | Medicaid | MO |
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Intervention Services | Past | Accepting new patients | |
| Behavior Intervention Services | Behavior Analyst | 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.
-
- Behavior Analyst
- Maryland Heights, MO
- NPI 1689732620
-
- Community/Behavioral Health Agency
- Saint Louis, MO
- NPI 1063648129
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1114102365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5389 ARSENAL ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631391401",
"telephone_number": "314-772-6933",
"fax_number": "314-772-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5389 ARSENAL ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631391401",
"telephone_number": "314-772-6933",
"fax_number": "314-772-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALLS",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-07",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "1-04-1947",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "856074703",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.