Active NPI
Jack Katze
- Music Therapist
- Crystal City, MO
National Provider Identifier
1407703739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 17728
- Practice address
- 2310 N Truman Blvd Ste C
Crystal City, MO 63019-1037 - Phone
- (636) 232-6459
- NPI assigned
- Mar 16, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 17728 | MO | Primary |
Addresses
Primary practice location
2310 N Truman Blvd Ste C
Crystal City, MO 63019-1037
Mailing address
100 Sherry Dr
Belleville, IL 62220-3055
Phone (901) 237-8932
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17728 | MO | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1407703739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SHERRY DR",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622203055",
"telephone_number": "901-237-8932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 N TRUMAN BLVD STE C",
"city": "CRYSTAL CITY",
"state": "MO",
"postal_code": "630191037",
"telephone_number": "636-232-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATZE",
"first_name": "JACK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-03-16",
"last_updated": "2026-03-16",
"certification_date": "2026-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "MO",
"license": "17728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.