Individual provider Active NPI

George J Kamps, MSW,ACSW, LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1134119456
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2341-123 Issued in WI
Practice address
1922 University Ave
Green Bay, WI 54302-1880
Phone
(920) 432-0600
Fax
(920) 432-9194
NPI assigned
Oct 27, 2005
Last updated
Jan 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2341-123 WI Primary

Addresses

Primary practice location

1922 University Ave
Green Bay, WI 54302-1880

Mailing address

PO Box 8067
Green Bay, WI 54308-8067
Phone (920) 432-0600

Other identifiers 1

IdentifierTypeStateIssuer
39500800MedicaidWI

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
2341-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1134119456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8067",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543088067",
            "telephone_number": "920-432-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 UNIVERSITY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021880",
            "telephone_number": "920-432-0600",
            "fax_number": "920-432-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMPS",
        "first_name": "GEORGE",
        "middle_name": "J",
        "credential": "MSW,ACSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2341-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39500800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.