Individual provider Active NPI

Andres Mondragon, MSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1033550462
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P008236 Issued in NC
Practice address
315 E Washington St
Greensboro, NC 27401-2911
Phone
(336) 387-6161
NPI assigned
Jul 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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 P008236 NC Primary

Addresses

Primary practice location

315 E Washington St
Greensboro, NC 27401-2911

Mailing address

902 Bonner Dr.
Jamestown Site
Jamestown, NC 27282
Phone (336) 387-6161

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
I20151103001813 NC Practitioner - Clinical Social Worker 0042520033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 E Washington St
Greensboro, NC 27401-2911
Phone (336) 387-6161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P008236NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of the Piedmont, Inc CurrentSince Sep 2, 2015 Accepting new patients
Family Service of the Piedmont, Inc. Clinical CurrentSince Sep 2, 2015 Accepting new patients

Locations

315 E Washington St
Greensboro, NC 27401
Phone (336) 387-6161

1401 Long St
High Point, NC 27262
Phone (336) 387-6161

902 Bonner Dr
Jamestown, NC 27282
Phone (336) 387-6161

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1033550462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BONNER DR.",
            "address_2": "JAMESTOWN SITE",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "27282",
            "telephone_number": "336-387-6161",
            "fax_number": "336-387-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E WASHINGTON ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012911",
            "telephone_number": "336-387-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDRAGON",
        "first_name": "ANDRES",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.