Katelyn Paige Souders

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2016025596 Issued in MO

Practice address

1628 Oklahoma Ave
Trenton, MO 64683-2565

Phone

(660) 359-4600

Fax

(660) 359-4286

NPI assigned

Feb 9, 2022

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 names 1

• Kate Eads Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1760136634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 OKLAHOMA AVE",
            "city": "TRENTON",
            "state": "MO",
            "postal_code": "646832565",
            "telephone_number": "660-359-4600",
            "fax_number": "660-359-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDERS",
        "first_name": "KATELYN",
        "middle_name": "PAIGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2016025596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "EADS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jjoseph Goodin Slonecker
• Frederick R Smith, MA
• Khannah Marlitt-Marie Smith, MD
• Jason Jimmy So, M.D.
• Jennifer C Soriano, PT
• Tammie Elaine Spencer
• Leslie E Stanley, LCSW
• Deri Drianne Stiles
• Dawn Yvette Stout, RN, BCFNP
• Katie J Street, LPN

• Licensed Practical Nurse in Trenton, MO
• Providers in Trenton, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.