Individual provider Active NPI

Eric C Hedberg, LCSW, LCAS-A

  • Clinical Social Worker
  • Williamston, NC
National Provider Identifier
1013447887
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P011504 Issued in NC
Practice address
210 W Liberty St
Williamston, NC 27892-1712
Phone
(252) 792-5151
NPI assigned
Jun 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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 P011504 NC Primary

Addresses

Primary practice location

210 W Liberty St
Williamston, NC 27892-1712

Mailing address

PO Box 8423
Greenville, NC 27835-8423
Phone (252) 847-2181

Other practice location 1

1308 Highland Dr
Washington, NC 27889-3485
Phone (252) 946-3666

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehedberg282201@direct.vidanthealth.com

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
I20190124002323 NC Practitioner - Clinical Social Worker 4082806682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

1308 Highland Dr
Washington, NC 27889-3424
Phone (252) 946-3666

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jul 12, 2019 Accepting new patients
Vidant Medical Group LLC CurrentSince Jul 12, 2019 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1308 Highland Dr
Washington, NC 27889
Phone (252) 946-3666

210 W Liberty St
Williamston, NC 27892
Phone (252) 792-5151

Interoperability endpoints

  • Direct secure messaging: ehedberg282201@direct.vidanthealth.com

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1013447887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8423",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278358423",
            "telephone_number": "252-847-2181",
            "fax_number": "252-847-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W LIBERTY ST",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278921712",
            "telephone_number": "252-792-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "NC",
            "postal_code": "278893485",
            "country_code": "US",
            "telephone_number": "252-946-3666",
            "fax_number": "252-975-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDBERG",
        "first_name": "ERIC",
        "middle_name": "C",
        "credential": "LCSW, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehedberg282201@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamston, NC

Sources for this page

Verify at the official NPI Registry.