Organization Active NPI

Kints LLC

  • Adult Mental Health Clinic/Center
  • Chesterfield, MO
National Provider Identifier
1336772912
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
KINTS LLC
Practice address
100 Chesterfield Business Pkwy Ste 200
Chesterfield, MO 63005-1271
Phone
(636) 825-2200
Fax
(636) 825-2201
NPI assigned
Feb 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Dr. Teide Brisibe Ehimare, MDNPI 1982804704
Title
Owner
Phone
(573) 639-0057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

100 Chesterfield Business Pkwy Ste 200
Chesterfield, MO 63005-1271

Mailing address

500 N Main St Ste 620
Roswell, NM 88201-4767
Phone (808) 909-2003

Other practice location 1

11325 Saint Charles Rock Rd
Bridgeton, MO 63044-2722
Phone (636) 825-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200422002851 MO Part B Supplier - Clinic/Group Practice 4284064882 Receives reassigned benefits from 1 practitioner
Practice locations: Bridgeton, MO; Chesterfield, MO; Wildwood, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1336772912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST STE 620",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014767",
            "telephone_number": "808-909-2003",
            "fax_number": "808-909-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHESTERFIELD BUSINESS PKWY STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051271",
            "telephone_number": "636-825-2200",
            "fax_number": "636-825-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11325 Saint Charles Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442722",
            "country_code": "US",
            "telephone_number": "636-825-2200",
            "fax_number": "636-825-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "EHIMARE",
        "authorized_official_first_name": "TEIDE",
        "authorized_official_middle_name": "BRISIBE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-639-0057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.