Active NPI
Kathy Jo Loughren, NNP
- Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1457337222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP3305452
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y9326 | Other | FL | BCBS |
| 303542500 | Medicaid | FL | |
| Y9326 | Other | BCBS |
Other names 1
- Kathy Jo Underwood
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 |
|---|---|---|---|
| ARNP3305452 | FL | MD | Nurse Practitioner |
| 085789 | MO | MD | Neonatal 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.