Individual provider Active NPI

Victoria N Johnson, CD(DONA)

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1003545609
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C018083 Issued in NC
Practice address
6118 Saint Giles St Ste 120
Raleigh, NC 27612-7045
Phone
(252) 955-4293
NPI assigned
Jun 8, 2022
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X 14774 NC
Clinical Social Worker 1041C0700X C018083 NC Primary

Addresses

Primary practice location

6118 Saint Giles St Ste 120
Raleigh, NC 27612-7045

Mailing address

4501 New Bern Avenue
Suite 130- Box 261
Raleigh, NC 27610
Phone (252) 955-4293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260616001102 NC Practitioner - Clinical Social Worker 5991277444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1011 Rock Quarry Rd
Raleigh, NC 27610-3825

1425 Promise Beacon Cir
Suite 215
Raleigh, NC 27610-3955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C018083NCMDClinical Social Worker
14774NCMDDoula

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1003545609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 NEW BERN AVENUE",
            "address_2": "SUITE 130- BOX 261",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27610",
            "telephone_number": "252-955-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6118 SAINT GILES ST STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127045",
            "telephone_number": "252-955-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICTORIA",
        "middle_name": "N",
        "credential": "CD(DONA)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NC",
            "license": "14774",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C018083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.