Individual provider Active NPI

Eileen D Kinsella, LMT, NCBTMB

  • Specialist
  • Saint Louis, MO
National Provider Identifier
1780924332
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2001027022 Issued in MO
Practice address
6816 Scanlan Ave
Saint Louis, MO 63139-2539
Phone
(314) 608-3862
NPI assigned
Feb 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2001027022 MO Primary
Specialist 174400000X 004180-00 MO

Addresses

Primary practice location

6816 Scanlan Ave
Saint Louis, MO 63139-2539

Mailing address

6816 Scanlan Ave
Saint Louis, MO 63139-2539
Phone (314) 608-3862

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

LicenseStateTypeSpecialty
004180-00MOMDSpecialist
2001027022MOMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1780924332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6816 SCANLAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392539",
            "telephone_number": "314-608-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6816 SCANLAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392539",
            "telephone_number": "314-608-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "EILEEN",
        "middle_name": "D",
        "credential": "LMT, NCBTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2001027022",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "004180-00",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Feb 19, 2013; 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.