Active NPI
Kim Stevens, RDH BS MBA OM
- Developmental Therapist
- Quincy, IL
National Provider Identifier
1134543168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 001181
- Practice address
- 3921 S 24TH St
Quincy, IL 62305-8925 - Phone
- (573) 231-6385
- NPI assigned
- Feb 11, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 001181 | MO | Primary |
Addresses
Primary practice location
3921 S 24TH St
Quincy, IL 62305-8925
Mailing address
3921 S 24TH St
Quincy, IL 62305-8925
Phone (573) 231-6385
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
- Bachelor of Science, Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001181 | MO | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1134543168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3921 S 24TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623058925",
"telephone_number": "573-231-6385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3921 S 24TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623058925",
"telephone_number": "573-231-6385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "KIM",
"credential": "RDH BS MBA OM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-11",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "MO",
"license": "001181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.