Individual provider Active NPI

Michael Andrew Larkey, CAPSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1851622005
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127420121 Issued in WI
Practice address
815 Reber St
Green Bay, WI 54302-1116
Phone
(920) 438-0056
NPI assigned
Jan 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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 127420121 WI Primary

Addresses

Primary practice location

815 Reber St
Green Bay, WI 54302-1116

Mailing address

815 Reber St
Green Bay, WI 54302-1116
Phone (920) 438-0056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20150402001178 WI Practitioner - Clinical Social Worker 7012234966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127420121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Mar 5, 2015 Accepting new patients
Thedacare, Incorporated CurrentSince Mar 5, 2015 Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1095 Midway Rd
Menasha, WI 54952
Phone (920) 720-3700

Organizations & group practices 2

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": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1851622005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 REBER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021116",
            "telephone_number": "920-438-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 REBER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021116",
            "telephone_number": "920-438-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARKEY",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "CAPSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "127420121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.