Individual provider Active NPI

Michael W Kemp, MS

  • Audiologist
  • Sacramento, CA
National Provider Identifier
1669533030
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU1640 Issued in CA
Practice address
2620 Hurley Way Ste B
Sacramento, CA 95864-3789
Phone
(916) 483-9064
Fax
(916) 483-3514
NPI assigned
Dec 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU1640 CA Primary

Addresses

Primary practice location

2620 Hurley Way Ste B
Sacramento, CA 95864-3789

Mailing address

2620 Hurley Way Ste B
Sacramento, CA 95864-3789
Phone (916) 483-9064

Other identifiers 1

IdentifierTypeStateIssuer
5610328MedicaidCA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AU1640CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Hearing Aid Center, Inc Audiologist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669533030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 HURLEY WAY STE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958643789",
            "telephone_number": "916-483-9064",
            "fax_number": "916-483-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 HURLEY WAY STE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958643789",
            "telephone_number": "916-483-9064",
            "fax_number": "916-483-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU1640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5610328",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.