Christine D Kornbluth, LCSW, ACSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004695 Issued in MO

Practice address

1800 Community
Clinton, MO 64735-8804

Phone

(888) 403-1071

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mrs. Chris D Klofkorn Former name

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1902975048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Center Dr",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "MO",
            "postal_code": "646282056",
            "country_code": "US",
            "telephone_number": "660-258-7810",
            "fax_number": "660-258-7810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNBLUTH",
        "first_name": "CHRISTINE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LCSW, ACSW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497752204",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497752246",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "10001133600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "27108011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "KLOFKORN",
            "middle_name": "D",
            "prefix": "MRS.",
            "credential": "LCSW, ACSW, MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tina Kliethermes, LPN
• Stephanie J. Klopfer, MED, LPC
• Sarah Elizabeth Klos, LCSW
• Robert Duaine Knapp, D.D.S.
• Pamela J. Knowles, RN
• Alaa Kozaat
• Kreisler Clnic Pharmacy
• Kreisler Drug #3
• Kreisler Drug #3 Inc.
• Kreisler Drug Co. Inc.

• Clinical Social Worker in Clinton, MO
• Providers in Clinton, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.