Kimberly Kay Yeagle, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004461 Issued in MO

Practice address

1902 Osage Dr
Columbia, MO 65202-5476

Phone

(573) 474-2984

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594425600000",
    "number": "1164408936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 OSAGE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652025476",
            "telephone_number": "573-474-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 OSAGE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652025476",
            "telephone_number": "573-474-2984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 E Monroe St",
            "address_purpose": "LOCATION",
            "city": "Mexico",
            "state": "MO",
            "postal_code": "652652919",
            "country_code": "US",
            "telephone_number": "573-582-8406",
            "fax_number": "573-582-3706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1902 Osage Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652025476",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEAGLE",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497695130",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MISSOURI LICENSE",
            "identifier": "004461",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muhammad Yasir, MD
• Mona Yasrebi, MD
• Arsany Yassa, MD
• Chelsea Gordon Yates
• Jared D Yates
• Shannon Elizabeth Yehyawi, MD
• Tameem Mahmoud Yehyawi, M.D.
• Anudeep Yelam, MD
• Lisa Marie Yeo
• Preethi Yerram, M.D.

• Clinical Social Worker in Columbia, MO
• Providers in Columbia, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.