Individual provider Active NPI

Kittie A Rogers, MSW, LCSW

  • Counselor
  • Columbia, MO
National Provider Identifier
1144229428
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
002690 Issued in MO
Practice address
2100 E Broadway Ste 217B
Columbia, MO 65201-6082
Phone
(573) 529-0732
NPI assigned
Jul 19, 2005
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 002690 MO Primary

Addresses

Primary practice location

2100 E Broadway Ste 217B
Columbia, MO 65201-6082

Mailing address

504 N William St
Columbia, MO 65201-5654
Phone (573) 529-0732

Other identifiers 4

IdentifierTypeStateIssuer
187340OtherMOBCBS
506201904OtherMOHCY MEDICAID NUMBER
497810218MedicaidMO
187340OtherMOANTHEM EAP

Other names 1

  • Kathleen A Rogers Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101113000134 MO Practitioner - Clinical Social Worker 6800081001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2100 E Broadway
Suite 217B
Columbia, MO 65201-6082
Phone (573) 529-0732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002690MOMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Anodyne Therapy, LLC CurrentSince Jun 5, 2012 Accepting new patients

Locations

2100 E Broadway
Ste 217B
Columbia, MO 65201
Phone (573) 529-0732

1204 Rogers St
Ste D
Columbia, MO 65201
Phone (573) 268-6846

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1144229428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N WILLIAM ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015654",
            "telephone_number": "573-529-0732",
            "fax_number": "573-875-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E BROADWAY STE 217B",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016082",
            "telephone_number": "573-529-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KITTIE",
        "middle_name": "A",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "002690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "187340",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCY MEDICAID NUMBER",
            "identifier": "506201904",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497810218",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM EAP",
            "identifier": "187340",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "ROGERS",
            "middle_name": "A",
            "credential": "MSW, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.