Kacy Ann Emge, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2018009252 Issued in MO

Practice address

12655 Olive Blvd FL 4
Saint Louis, MO 63141-6291

Phone

(314) 851-1000

Fax

(314) 851-4445

NPI assigned

Feb 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kacy Ann Shaffer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1235637562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-851-1000",
            "fax_number": "314-851-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 OLIVE BLVD FL 4",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416291",
            "telephone_number": "314-851-1000",
            "fax_number": "314-851-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMGE",
        "first_name": "KACY",
        "middle_name": "ANN",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2018009252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACY",
            "last_name": "SHAFFER",
            "middle_name": "ANN",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Sue Emert-Smiley, LCSW
• Debra W Emery, PH.D.
• Hannah Emery, PHD
• Robert Eric Emery, D.D.S.
• Valerie Beckham Emery, ANP
• Emily Murray
• Amanda Renee Emke, MD
• Emmanuel Outreach Ministries
• Deborah Annette Emmelkamp
• Lisa Renee Emmenegger, PH.D.

• Registered Dietitian in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.