Active NPI
Regina Marie Kimbrough
- Psychologist
- Saint Charles, MO
National Provider Identifier
1710314786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2025009599
- Practice address
- 6009 Suntan Drive
Saint Charles, MO 63301-8488 - Phone
- (202) 374-4149
- NPI assigned
- Oct 4, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2025009599 | MO | Primary |
Addresses
Primary practice location
6009 Suntan Drive
Saint Charles, MO 63301-8488
Mailing address
6009 Suntan Dr
Saint Charles, MO 63301-8488
Phone (202) 374-3149
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 |
|---|---|---|---|
| 2025009599 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768435200000",
"number": "1710314786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6009 SUNTAN DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633018488",
"telephone_number": "202-374-3149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6009 SUNTAN DRIVE",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633018488",
"telephone_number": "202-374-4149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBROUGH",
"first_name": "REGINA",
"middle_name": "MARIE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-04",
"last_updated": "2026-01-15",
"certification_date": "2026-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "2025009599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.