Active NPI
Janis C Raynor, LCSW
- Clinical Social Worker
- Fort Gordon, GA
National Provider Identifier
1003974445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 38409
- Practice address
- 300 W Hospital Rd
Ddeamc
Fort Gordon, GA 30905-5741 - Phone
- (706) 787-9186
- Fax
- (706) 787-3562
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- 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 | 38409 | TX | Primary |
Addresses
Primary practice location
300 W Hospital Rd
Ddeamc
Fort Gordon, GA 30905-5741
Mailing address
300 W Hospital Rd # 13a-10
Ddeamc
Fort Gordon, GA 30905-5741
Phone (706) 787-9186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38409 | Other | TX | LCSW-C |
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 |
|---|---|---|---|
| 38409 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1003974445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W HOSPITAL RD # 13A-10",
"address_2": "DDEAMC",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055741",
"telephone_number": "706-787-9186",
"fax_number": "706-787-8991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W HOSPITAL RD",
"address_2": "DDEAMC",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055741",
"telephone_number": "706-787-9186",
"fax_number": "706-787-3562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYNOR",
"first_name": "JANIS",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "38409",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW-C",
"identifier": "38409",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.