Active NPI
Kurt Kananen, APSW
- Clinical Social Worker
- Green Bay, WI
National Provider Identifier
1902626203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13064
- Practice address
- 3150 Gershwin Dr
Green Bay, WI 54311-4328 - Phone
- (920) 391-4700
- Fax
- (920) 391-4731
- NPI assigned
- Oct 12, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 134996 | WI | |
| Clinical Social Worker | 1041C0700X | 13064 | WI | Primary |
Addresses
Primary practice location
3150 Gershwin Dr
Green Bay, WI 54311-4328
Mailing address
3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone (920) 391-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3150 Gershwin Dr
Green Bay, WI 54311-4328
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134996 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1902626203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 GERSHWIN DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543114328",
"telephone_number": "920-391-4700",
"fax_number": "920-391-4731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 GERSHWIN DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543114328",
"telephone_number": "920-391-4700",
"fax_number": "920-391-4731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANANEN",
"first_name": "KURT",
"credential": "APSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-12",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "134996",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "13064",
"primary": true
}
],
"identifiers": [],
"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 Jul 13, 2026; 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.