Individual provider Active NPI

Kellie Ann Loughmiller, LMSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1275820540
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2016018313 Issued in MO
Practice address
111 N 15TH St
Apt. 912
Saint Louis, MO 63103-1988
Phone
(573) 579-7176
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 2016018313 MO Primary

Addresses

Primary practice location

111 N 15TH St
Apt. 912
Saint Louis, MO 63103-1988

Mailing address

111 N 15TH St
Apt. 912
Saint Louis, MO 63103-1988
Phone (573) 579-7176

Other identifiers 1

IdentifierTypeStateIssuer
2016018313OtherMOLICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1275820540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N 15TH ST",
            "address_2": "APT. 912",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031988",
            "telephone_number": "573-579-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N 15TH ST",
            "address_2": "APT. 912",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031988",
            "telephone_number": "573-579-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHMILLER",
        "first_name": "KELLIE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016018313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2016018313",
            "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 Apr 18, 2017; 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.