Individual provider Active NPI

Kelly R. Phillips, LCSW

  • Clinical Social Worker
  • Raymore, MO
National Provider Identifier
1407453178
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2025018371 Issued in MO
Practice address
501 N Sunset LN
Raymore, MO 64083-6408
Phone
(844) 853-8937
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2020018075 MO
Clinical Social Worker 1041C0700X 2025018371 MO Primary

Addresses

Primary practice location

501 N Sunset LN
Raymore, MO 64083-6408

Mailing address

3801 Blue Pkwy
Kansas City, MO 64130-2807
Phone (816) 599-5267

Other identifiers 1

IdentifierTypeStateIssuer
2020018075OtherMOSTATE LICENSE

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
I20250604003936 MO Practitioner - Clinical Social Worker 9931618469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians

Practice addresses (Care Compare)

860 Lynn St
Lebanon, MO 65536-3810
Phone (888) 403-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020018075MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince May 23, 2025 Accepting new patients
Compass Health, Inc Clinical CurrentSince May 23, 2025 Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

860 Lynn St
Lebanon, MO 65536
Phone (417) 334-8337

501 N Sunset Ln
Raymore, MO 64083
Phone (448) 538-9378

1010 Remington Plz
Raymore, MO 64083
Phone (816) 318-4430

Organizations & group practices 2

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1407453178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 BLUE PKWY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641302807",
            "telephone_number": "816-599-5267",
            "fax_number": "816-599-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N SUNSET LN",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640836408",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KELLY",
        "middle_name": "R.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2020018075",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2025018371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2020018075",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

Verify at the official NPI Registry.