Individual provider Active NPI

Stephen Michael Kanne, PHD

  • Clinical Child & Adolescent Psychologist
  • Columbia, MO
National Provider Identifier
1780648014
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
2000166652 Issued in MO
Practice address
701 Veterans United Dr
Columbia, MO 65201-4236
Phone
(573) 884-6052
Fax
(573) 884-1151
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2000166652 MO
Clinical Child & Adolescent Psychologist 103TC2200X 2000166652 MO Primary
Psychologist 103T00000X 2000166652 MO

Addresses

Primary practice location

701 Veterans United Dr
Columbia, MO 65201-4236

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060214000050 MO Practitioner - Clinical Psychologist 7810902756 Reassigns benefits to 1 organization
I20250123001785 NY Practitioner - Clinical Psychologist 7810902756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
36038TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Psychologist CurrentSince Nov 22, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Nov 22, 2024 Accepting new patients

Locations

156 William St
New York, NY 10038
Phone (646) 962-4679

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

21 Bloomingdale Rd
White Plains, NY 10605
Phone (914) 682-9100

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1780648014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 VETERANS UNITED DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014236",
            "telephone_number": "573-884-6052",
            "fax_number": "573-884-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNE",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2000166652",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MO",
            "license": "2000166652",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2000166652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "205 Portland St",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652016521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.