Kelley Samuels-Good

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

527 Cobb St
Cadillac, MI 49601-2540

Phone

(231) 775-3463

NPI assigned

Sep 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Lakes Community Mental Health AuthorityGroup PAC ID 8022921154, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northern Lakes Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Traverse City, MI
  • NPI 1669572657
  Medicare reassignment Care Compare group NPD
• Northern Lakes Community Mental Health Authority

  • Clinic/Center
  • Traverse City, MI
  • NPI 1417481136
  NPD

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1841748977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HALL ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842288",
            "telephone_number": "231-922-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012540",
            "telephone_number": "231-775-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS-GOOD",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon William Ryan
• Elizabeth Whitney Rzepkaalto, MD
• Saginaw Vamc
• Saige Twombly Psychology PLLC
• Samaritas
• Joseph D Santangelo, M.D.
• Megan M Santangelo, M.D.
• Ted G Sarna
• Haley Satchell
• Caitlyn Schepers

• Social Worker in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.