Individual provider Active NPI

Maureen Kemmerer, LICSW

  • Clinical Social Worker
  • Merrimac, MA
National Provider Identifier
1306055686
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117067 Issued in MA
Practice address
10 Little Pond Rd
Merrimac, MA 01860-2254
Phone
(978) 618-8229
NPI assigned
May 22, 2007
Last updated
May 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2014

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 117067 MA Primary

Addresses

Primary practice location

10 Little Pond Rd
Merrimac, MA 01860-2254

Mailing address

10 Little Pond Rd
Merrimac, MA 01860-2254
Phone (978) 618-8229

Other identifiers 1

IdentifierTypeStateIssuer
1305638MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121030000137 MA Practitioner - Clinical Social Worker 2264682186 Practice locations: Newbury Port, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 Green St
Newburyport, MA 01950-2650
Phone (978) 618-8229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1306055686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LITTLE POND RD",
            "city": "MERRIMAC",
            "state": "MA",
            "postal_code": "018602254",
            "telephone_number": "978-618-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LITTLE POND RD",
            "city": "MERRIMAC",
            "state": "MA",
            "postal_code": "018602254",
            "telephone_number": "978-618-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMMERER",
        "first_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305638",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrimac, MA

Sources for this page

Verify at the official NPI Registry.