Active NPI
Janet W Kwan, PHD
- Clinical Psychologist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2020014107
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 577-5667
- NPI assigned
- Sep 5, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2020014107 | MO | Primary |
| Clinical Psychologist | 103TC0700X | 19-09P | AR |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Other practice location 1
9601 Baptist Health Dr Ste 1050
Little Rock, AR 72205-6379
Phone (501) 228-7400
Other practice location 2
3800 Park Ave Fl 2
Saint Louis, MO 63110-2514
Phone (314) 577-5667
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jkwan375768@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19-09P | AR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Associates of Arkansas PLLC | Current | Accepting new patients | |
| SSM Cardinal Glennon Children'S Hospital | Current | Accepting new patients | |
| SSM Cardinal Glennon Childrens Hospital | Current | Accepting new patients |
Locations
9601 Baptist Health Dr
Ste 1050
Little Rock, AR 72205
Phone (501) 228-7400
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
3800 Park Ave
Fl 2
Saint Louis, MO 63110
Phone (314) 577-5600
1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
Interoperability endpoints
- jkwan375768@direct-ehr-ssmhc.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Warrenton, MO
- NPI 1962573212
-
- Psychiatry Physician
- Little Rock, AR
- NPI 1659439925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1598314213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-577-5667"
}
],
"practiceLocations": [
{
"address_1": "9601 Baptist Health Dr Ste 1050",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722056379",
"country_code": "US",
"telephone_number": "501-228-7400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3800 Park Ave Fl 2",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631102514",
"country_code": "US",
"telephone_number": "314-577-5667",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KWAN",
"first_name": "JANET",
"middle_name": "W",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-05",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2020014107",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "19-09P",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jkwan375768@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "jkwan375768@direct-ehr-ssmhc.com",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Nov 9, 2020; 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.