Individual provider Active NPI

Peter Sterrett, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1033111398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005505 Issued in NC
Practice address
433 W Main St
Durham, NC 27701-3217
Phone
(919) 433-0170
Fax
(919) 226-0026
NPI assigned
Jun 1, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904002496 VA
Clinical Social Worker 1041C0700X C005505 NC Primary

Addresses

Primary practice location

433 W Main St
Durham, NC 27701-3217

Mailing address

1005 Senoma PL
Apex, NC 27502-8982
Phone (919) 303-3425

Other identifiers 3

IdentifierTypeStateIssuer
9374511OtherVAPHCS
008912793MedicaidVA
776769000OtherVAMAGELLAN HEALTH SERVICES

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C005505NCMDClinical Social Worker
0904002496VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Ucp North Carolina & Virginia, Inc. Past Accepting new patients
Easter Seals Ucp North Carolina & Virginia, Inc. Past Accepting new patients
Hopelink Behavioral Health PastSince Nov 22, 1988 Accepting new patients

Organizations & group practices 3

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033111398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 SENOMA PL",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275028982",
            "telephone_number": "919-303-3425",
            "fax_number": "919-226-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W MAIN ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013217",
            "telephone_number": "919-433-0170",
            "fax_number": "919-226-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERRETT",
        "first_name": "PETER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002496",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9374511",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008912793",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "776769000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.