Active NPI
Kimberly Susan Iverson, MT-BC
- Music Therapist
- Saint Louis, MO
National Provider Identifier
1144130451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 15711
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 268-2700
- NPI assigned
- Sep 9, 2026
- Last updated
- Sep 9, 2026
- 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 |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 15711 | MO | Primary |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
9619 Labette Dr
Saint Louis, MO 63123-6622
Phone (701) 809-1207
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15711 | MO | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1144130451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9619 LABETTE DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631236622",
"telephone_number": "701-809-1207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-268-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVERSON",
"first_name": "KIMBERLY",
"middle_name": "SUSAN",
"credential": "MT-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-09",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "MO",
"license": "15711",
"primary": true
}
],
"identifiers": [],
"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 Sep 9, 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.