Kids' Harbor, Inc.

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

KIDS' HARBOR, INC.

Doing business as

Kids' Harbor Too

Practice address

5717 Chapel Dr.
Osage Beach, MO 65065

Phone

(573) 348-6886

Fax

(573) 348-6887

NPI assigned

Jan 20, 2006

Last updated

Aug 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Cara Gerdiman

Title

Executive Director

Phone

(573) 348-6886

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kids' Harbor Too Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Kids' Harbor Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kids' Harbor, Inc.

  dba Kids' Harbor Too

  • Voluntary or Charitable Agency
  • Saint Robert, MO
  • NPI 1841261799
  NPD tax ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lori R Blount, PLPC

  • Professional Counselor
  • Osage Beach, MO
  • NPI 1003661091
  NPD (past)
• Deborah B Doll, LPC, CCTP, NCC

  • Professional Counselor
  • Osage Beach, MO
  • NPI 1629726047
  NPD (past)
• Kaetlyn McKee Roberts, LPC

  • Professional Counselor
  • Osage Beach, MO
  • NPI 1639639966
  NPD (past)
• Ashley R. Wisdom, LPC

  • Professional Counselor
  • Washington, MO
  • NPI 1790566248
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1427038876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 CHAPEL DR.",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "65065",
            "telephone_number": "573-348-6886",
            "fax_number": "573-348-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 CHAPEL DR.",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "65065",
            "telephone_number": "573-348-6886",
            "fax_number": "573-348-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS' HARBOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "GERDIMAN",
        "authorized_official_first_name": "CARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-348-6886",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241989565",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206002909",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids' Harbor Too",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Lynn Keith, RPH, CGP
• David Andrew Kelley I, RPH
• Dennis Lee Kempf Jr., MS, CEP, EP, EIM
• Elizabeth Kermis, D.O.
• Zubair A Khan, MD
• David Kilpatrick I, PTA
• Brandi Nicole Kincaid, MSN, APRN, NP-C
• Robert D King, M.D.
• Corinne Anne Kirby, LMT
• Marcandrea Kish, COTA/L

• Voluntary or Charitable Agency in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Voluntary or Charitable Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.