Individual provider Active NPI

Keturah Jolene Farmer, LCSW

  • Social Worker
  • West Plains, MO
National Provider Identifier
1376197822
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2019029468 Issued in MO
Practice address
504 W Main St
West Plains, MO 65775-2732
Phone
(417) 252-0846
NPI assigned
Aug 1, 2019
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2019029468 MO Primary

Addresses

Primary practice location

504 W Main St
West Plains, MO 65775-2732

Mailing address

PO Box 1475
West Plains, MO 65775-1475
Phone (417) 815-4769

Other practice location 1

1211 Porter Wagoner Blvd, Ste. 23
West Plains, MO 65775
Phone (417) 257-6762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220422001759 MO Practitioner - Clinical Social Worker 4688061567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019029468MOMDSocial Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1376197822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751475",
            "telephone_number": "417-815-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W MAIN ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752732",
            "telephone_number": "417-252-0846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Porter Wagoner Blvd, Ste. 23",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "65775",
            "country_code": "US",
            "telephone_number": "417-257-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "KETURAH",
        "middle_name": "JOLENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2019029468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.