Active NPI
Keith Allen Kamphuis, LMSW
- Social Worker
- Gaylord, MI
National Provider Identifier
1194354050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4722G
- Practice address
- 814 S Otsego Ave
Gaylord, MI 49735-2708 - Phone
- (989) 732-7525
- Fax
- (989) 732-7522
- NPI assigned
- Apr 3, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 4722G | AL | Primary |
Addresses
Primary practice location
814 S Otsego Ave
Gaylord, MI 49735-2708
Mailing address
1500 Weiss St
Saginaw, MI 48602-5251
Phone (989) 497-2500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4722G | AL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585872000000",
"number": "1194354050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 WEISS ST",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486025251",
"telephone_number": "989-497-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 S OTSEGO AVE",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497352708",
"telephone_number": "989-732-7525",
"fax_number": "989-732-7522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMPHUIS",
"first_name": "KEITH",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-03",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AL",
"license": "4722G",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaylord, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.