Kimberly Sue Stark, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1999140545 Issued in MO

Practice address

321 W Young Ave Ste a
Warrensburg, MO 64093-1111

Phone

(816) 308-0246

Fax

(816) 566-0486

NPI assigned

Jun 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Country Crossroads Counseling LLC

  • Counselor
  • Kingsville, MO
  • NPI 1952705444
  Medicare reassignment NPD

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1972289270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 NW W HWY",
            "city": "KINGSVILLE",
            "state": "MO",
            "postal_code": "640619117",
            "telephone_number": "816-308-0246",
            "fax_number": "816-566-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W YOUNG AVE STE A",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931111",
            "telephone_number": "816-308-0246",
            "fax_number": "816-566-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "1999140545",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "1999140545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason C Snowden, M.D.
• Lauren Elizabeth Snyder, PT, DPT
• Braden M Spangler, CRNA
• Madalynn Ann Stammer, CF-SLP
• Sarah Stamper
• Kelsey Starman
• Mikayla M Stebbing
• Sheridan Steenburgen, NURSE PRACTITIONER
• Stephens Chiropractic Inc
• Stephens Chiropractic LLC

• Psychologist in Warrensburg, MO
• Providers in Warrensburg, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.