Active NPI
Lori G Kolwyck, LCSW
- Clinical Social Worker
- Cape Girardeau, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004221
- Practice address
- 1702 N Kingshighway St
Cape Girardeau, MO 63701-2122 - Phone
- (573) 339-2000
- Fax
- (573) 339-1876
- NPI assigned
- Aug 9, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 004221 | MO | |
| Clinical Social Worker | 1041C0700X | 004221 | MO | Primary |
Addresses
Primary practice location
1702 N Kingshighway St
Cape Girardeau, MO 63701-2122
Mailing address
PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583
Other names 1
- Lori G Hayden
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2130 E Jackson Blvd
Saint Francis Clinic Jackson
Jackson, MO 63755-2907
Phone (573) 243-3115
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004221 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cape Laboratory & Pathology, LC | Current | Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients |
Locations
3120 Independence St
Cape Girardeau, MO 63703
Phone (573) 240-8846
211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000
1702 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 339-0483
545 Broadridge Dr
Jackson, MO 63755
Phone (573) 243-1997
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Cape Girardeau, MO
- NPI 1356304489
-
- Anatomic Pathology & Clinical Pathology Physician
- Cape Girardeau, MO
- NPI 1801872726
-
- General Acute Care Hospital
- Cape Girardeau, MO
- NPI 1467412726
-
- Clinic/Center
- Jackson, MO
- NPI 1992502975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1215938568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 801143",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641801143",
"telephone_number": "573-331-5583",
"fax_number": "573-331-5079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 N KINGSHIGHWAY ST",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637012122",
"telephone_number": "573-339-2000",
"fax_number": "573-339-1876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLWYCK",
"first_name": "LORI",
"middle_name": "G",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "004221",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "004221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LORI",
"last_name": "HAYDEN",
"middle_name": "G",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.