Individual provider Active NPI

Sandra Sue Kammer, MSW

  • Clinical Social Worker
  • Fort Gratiot, MI
National Provider Identifier
1265548515
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801016997 Issued in MI
Practice address
3947 Arlington Ave
Fort Gratiot, MI 48059-3764
Phone
(810) 984-2250
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801016997 MI
Clinical Social Worker 1041C0700X 6801016997 MI Primary

Addresses

Primary practice location

3947 Arlington Ave
Fort Gratiot, MI 48059-3764

Mailing address

3947 Arlington Ave
Fort Gratiot, MI 48059-3764
Phone (810) 984-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20211201001550 MI Practitioner - Clinical Social Worker 9234043654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801016997MIMDClinical Social Worker

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1265548515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3947 ARLINGTON AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593764",
            "telephone_number": "810-984-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3947 ARLINGTON AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593764",
            "telephone_number": "810-984-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMER",
        "first_name": "SANDRA",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801016997",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801016997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

Verify at the official NPI Registry.