Individual provider Active NPI

Kerri Koehler-Butt

  • Clinical Social Worker
  • Independence, MO
National Provider Identifier
1255883146
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2002030047 Issued in MO
Practice address
150 E Kansas Ave
Independence, MO 64050-3916
Phone
(816) 974-7690
Fax
(816) 886-2670
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2002030047 MO Primary

Addresses

Primary practice location

150 E Kansas Ave
Independence, MO 64050-3916

Mailing address

801 SW Southgate Dr
Blue Springs, MO 64015-9760
Phone (816) 974-7690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2002030047MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1255883146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SW SOUTHGATE DR",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640159760",
            "telephone_number": "816-974-7690",
            "fax_number": "816-886-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E KANSAS AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640503916",
            "telephone_number": "816-974-7690",
            "fax_number": "816-886-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER-BUTT",
        "first_name": "KERRI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002030047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.