Active NPI
Kevin Carpenter
- Clinical Psychologist
- Gladstone, MO
National Provider Identifier
1134664857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2019012713
- Practice address
- 5600 NE Antioch Rd
Suite 214
Gladstone, MO 64119 - Phone
- (816) 659-1478
- NPI assigned
- Jan 4, 2017
- Last updated
- Nov 21, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2019012713 | MO | Primary |
Addresses
Primary practice location
5600 NE Antioch Rd
Suite 214
Gladstone, MO 64119
Mailing address
22 Gates Dr
Platte City, MO 64079-9656
Phone (805) 657-5427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019012713 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1134664857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 GATES DR",
"city": "PLATTE CITY",
"state": "MO",
"postal_code": "640799656",
"telephone_number": "805-657-5427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 NE ANTIOCH RD",
"address_2": "SUITE 214",
"city": "GLADSTONE",
"state": "MO",
"postal_code": "64119",
"telephone_number": "816-659-1478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-04",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2019012713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladstone, MO
- Care Network of Gladstone LLC
- Carella Chiropractic
- Franklyn Ralph Carella, D.C.
- Steve R Carlson, DDS
- Adalin Carney
- CC Counseling Solutions LLC
- CCRC of Gladstone, LLC (Linden Woods Village)
- Alyson R Cecil, PHARMD
- Centerwell Senior Primary Care (Mo) PC (CenterWell Senior Primary Care- Gladstone)
- CFC Solutions Inc. (Saigon Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.