Active NPI
Kim Alan Pearson, M.S.W.
- Clinical Social Worker
- Mount Vernon, MO
National Provider Identifier
1376567438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1854
- Practice address
- 600 N Main St
Mount Vernon, MO 65712-1004 - Phone
- (417) 466-0160
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1854 | SD | Primary |
Addresses
Primary practice location
600 N Main St
Mount Vernon, MO 65712-1004
Mailing address
600 N Main St
Mount Vernon, MO 65712-1004
Phone (417) 466-0160
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376567438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N MAIN ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657121004",
"telephone_number": "417-466-0160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N MAIN ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657121004",
"telephone_number": "417-466-0160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "KIM",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "M.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SD",
"license": "1854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, 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.