Active NPI
Thomas Michael Bekkers, MSW
- Clinical Social Worker
- Green Bay, WI
National Provider Identifier
1871605014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 448-121
- Practice address
- 835 S Van Buren St
Green Bay, WI 54301-3526 - Phone
- (920) 433-0111
- Fax
- (920) 433-8765
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 448-121 | WI | Primary |
Addresses
Primary practice location
835 S Van Buren St
Green Bay, WI 54301-3526
Mailing address
PO Box 13508
Green Bay, WI 54307-3508
Phone (920) 433-0111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39762800 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 448-121 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Clinical | Past | Accepting new patients |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Past | Accepting new patients |
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.
-
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- NPI 1609894468
-
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- Green Bay, WI
- NPI 1689694911
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1871605014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13508",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543073508",
"telephone_number": "920-433-0111",
"fax_number": "920-433-8765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 S VAN BUREN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013526",
"telephone_number": "920-433-0111",
"fax_number": "920-433-8765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEKKERS",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "448-121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39762800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.