Individual provider Active NPI

Kristina L Camp, MSW

  • Counselor
  • Indianapolis, IN
National Provider Identifier
1063676930
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
615 N Alabama St Ste 320
Indianapolis, IN 46204-1432
Phone
(317) 644-6412
Fax
(317) 464-9575
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IN Primary

Addresses

Primary practice location

615 N Alabama St Ste 320
Indianapolis, IN 46204-1432

Mailing address

615 N Alabama St Ste 320
Indianapolis, IN 46204-1432
Phone (317) 644-6412

Other identifiers 1

IdentifierTypeStateIssuer
100264520MedicaidIN

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

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1063676930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N ALABAMA ST STE 320",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041432",
            "telephone_number": "317-644-6412",
            "fax_number": "317-464-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N ALABAMA ST STE 320",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041432",
            "telephone_number": "317-644-6412",
            "fax_number": "317-464-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMP",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.