Individual provider Active NPI

Fonda L. Kaiser, LCSW

  • Clinical Social Worker
  • Cape Girardeau, MO
National Provider Identifier
1366460503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002551 Issued in MO
Practice address
1427 Thomas Dr
Suite 204
Cape Girardeau, MO 63701-2129
Phone
(573) 334-7995
Fax
(573) 335-8610
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

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 002551 MO Primary

Addresses

Primary practice location

1427 Thomas Dr
Suite 204
Cape Girardeau, MO 63701-2129

Mailing address

1427 Thomas Dr
Suite 204
Cape Girardeau, MO 63701-2129
Phone (573) 334-7995

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
002551MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
4 Sight Counseling Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366460503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 THOMAS DR",
            "address_2": "SUITE 204",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012129",
            "telephone_number": "573-334-7995",
            "fax_number": "573-335-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 THOMAS DR",
            "address_2": "SUITE 204",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012129",
            "telephone_number": "573-334-7995",
            "fax_number": "573-335-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "FONDA",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "002551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, 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.