Individual provider Active NPI

Michael Kampa, A.T.R.

  • Athletic Trainer
  • Sartell, MN
National Provider Identifier
1497123020
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2606 Issued in MN
Practice address
1901 Connecticut Ave S
Sartell, MN 56377-2554
Phone
(320) 259-4100
NPI assigned
Sep 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2606 MN Primary

Addresses

Primary practice location

1901 Connecticut Ave S
Sartell, MN 56377-2554

Mailing address

529 20TH Ave N
Sartell, MN 56377-1686

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
2606MNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1497123020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 20TH AVE N",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CONNECTICUT AVE S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772554",
            "telephone_number": "320-259-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMPA",
        "first_name": "MICHAEL",
        "credential": "A.T.R.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.