Individual provider Active NPI

Kathy Jo Loughren, NNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1457337222
Registry record updated Dec 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3305452 Issued in FL
Practice address
3801 Wyoming St
Saint Louis, MO 63116-4840
Phone
(314) 332-2395
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X ARNP3305452 FL
Nurse Practitioner 363L00000X ARNP3305452 FL Primary
Neonatal Nurse Practitioner 363LN0000X 085789 MO
Lactation Consultant (Registered Nurse) 163WL0100X 085789 MO

Addresses

Primary practice location

3801 Wyoming St
Saint Louis, MO 63116-4840

Mailing address

3801 Wyoming St
Saint Louis, MO 63116-4840
Phone (314) 332-2395

Other identifiers 3

IdentifierTypeStateIssuer
Y9326OtherFLBCBS
303542500MedicaidFL
Y9326OtherBCBS

Other names 1

  • Kathy Jo Underwood Former name

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

LicenseStateTypeSpecialty
ARNP3305452FLMDNurse Practitioner
085789MOMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419379200000",
    "number": "1457337222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WYOMING ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164840",
            "telephone_number": "314-332-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WYOMING ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164840",
            "telephone_number": "314-332-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHREN",
        "first_name": "KATHY",
        "middle_name": "JO",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2014-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "ARNP3305452",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3305452",
            "primary": true
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MO",
            "license": "085789",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MO",
            "license": "085789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y9326",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303542500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y9326",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "UNDERWOOD",
            "middle_name": "JO",
            "credential": "NNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.