Active NPI
Kimberly K Mundt, M.S.
- Professional Counselor
- Monett, MO
National Provider Identifier
1871925529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2013026556
- Practice address
- 1701 N Central Ave.
Monett, MO 65708 - Phone
- (417) 476-1000
- NPI assigned
- Aug 5, 2013
- Last updated
- Aug 5, 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2013026556 | MO | Primary |
Addresses
Primary practice location
1701 N Central Ave.
Monett, MO 65708
Mailing address
PO Box 100
Pierce City, MO 65723-2100
Phone (417) 476-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013026556 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375660800000",
"number": "1871925529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "PIERCE CITY",
"state": "MO",
"postal_code": "657232100",
"telephone_number": "417-476-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N CENTRAL AVE.",
"city": "MONETT",
"state": "MO",
"postal_code": "65708",
"telephone_number": "417-476-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNDT",
"first_name": "KIMBERLY",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-05",
"last_updated": "2013-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2013026556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monett, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.