Kim Anne Doerge, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004678 Issued in MO

Practice address

757 Tahlequah LN
Cape Girardeau, MO 63701-8145

Phone

(636) 328-5641

NPI assigned

Apr 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kim.doerge.1@30520.direct.athenahealth.com

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1497920060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 TAHLEQUAH LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637018145",
            "telephone_number": "636-328-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 TAHLEQUAH LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637018145",
            "telephone_number": "636-328-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERGE",
        "first_name": "KIM",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "004678",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James Dodd, D.O.
• Aaron Nicholas Dodge, PA-C
• Brooke Lynn Dodge, PA-C
• Heather K Dodson, M.D., FAAP
• Robert W Dodson, M.D.
• Jeremey Scott Dohogne, O.D.
• Mark Alan Donelson, ATC
• Victoria Olivia Dormeyer, MSW, LCSW
• Chandler William Dorris, CRNA
• Sarah Dorris

• Clinical Social Worker in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.