Kendra Krietsch

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2020029142 Issued in MO

Practice address

5114 Mid America PLZ # 3B
Saint Louis, MO 63129-0003

Phone

(314) 454-6069

NPI assigned

Jul 30, 2020

Last updated

Aug 18, 2022By the provider in NPPES

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• St. Louis Childrens Hospital

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Louis, MO
  • NPI 1710909486
  Medicare reassignment NPD
• St Louis Childrens Hospital

  • Pediatrics Physician
  • Saint Louis, MO
  • NPI 1598398950
  NPD
• St. Louis Childrens Hospital

  • Pediatrics Physician
  • Saint Louis, MO
  • NPI 1194246728
  NPD (past)

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1235748773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL STE 3N-14",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 MID AMERICA PLZ # 3B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290003",
            "telephone_number": "314-454-6069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 N Outer 40 Rd # 2B",
            "address_purpose": "LOCATION",
            "city": "Town and Country",
            "state": "MO",
            "postal_code": "630175941",
            "country_code": "US",
            "telephone_number": "314-454-6069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Pl # 3N-14",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101002",
            "country_code": "US",
            "telephone_number": "314-454-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRIETSCH",
        "first_name": "KENDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2020029142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Childrens Pl # 3N-14",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Russell Krieger, M.D.
• Carol A Krieger, L.AC., RN
• Francine M Kriegshauser
• James W Kriegshauser, M.D.
• Lawrence A Kriegshauser, M.D.
• Hannah R Krigman, MD
• Mariam Gabrielle Krikorian, DO
• Raffi K Krikorian, M.D.
• Mara Krill, D.M.D
• Rebecca Kay Krimmel, PTA

• Clinical Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.