Individual provider Active NPI

Peggy J. Keilholz, M.S.W.

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1265568935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001359 Issued in MO
Practice address
7700 Clayton Rd
Suite 309
Saint Louis, MO 63117-1328
Phone
(314) 781-9181
Fax
(314) 781-4883
NPI assigned
Feb 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 001359 MO Primary

Addresses

Primary practice location

7700 Clayton Rd
Suite 309
Saint Louis, MO 63117-1328

Mailing address

7700 Clayton Rd
Suite 309
Saint Louis, MO 63117-1328
Phone (314) 781-9181

Other identifiers 2

IdentifierTypeStateIssuer
057978OtherMOVALUE OPTIONS
11567394OtherMOAETNA (CAQH)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001359MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265568935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 CLAYTON RD",
            "address_2": "SUITE 309",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171328",
            "telephone_number": "314-781-9181",
            "fax_number": "314-781-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 CLAYTON RD",
            "address_2": "SUITE 309",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171328",
            "telephone_number": "314-781-9181",
            "fax_number": "314-781-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEILHOLZ",
        "first_name": "PEGGY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "001359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "057978",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA (CAQH)",
            "identifier": "11567394",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.