Individual provider Active NPI

Robert Alan Wheeler, LCSW

  • Clinical Social Worker
  • Wilson, NC
National Provider Identifier
1043223142
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
COO4864 Issued in NC
Practice address
100 Gold St NE
Wilson, NC 27893-4020
Phone
(252) 265-8434
Fax
(252) 206-4069
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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 COO4864 NC Primary

Addresses

Primary practice location

100 Gold St NE
Wilson, NC 27893-4020

Mailing address

100 Gold St NE
Wilson, NC 27893-4020
Phone (252) 265-8434

Other identifiers 2

IdentifierTypeStateIssuer
200179438OtherNCTAX ID #
6003174MedicaidNC

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
COO4864NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellsprings Center of Goldsboro,P.a. Past Accepting new patients
Linda Newsome LCSW & Associates PA Past Accepting new patients

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1043223142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GOLD ST NE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934020",
            "telephone_number": "252-265-8434",
            "fax_number": "252-206-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GOLD ST NE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934020",
            "telephone_number": "252-265-8434",
            "fax_number": "252-206-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "COO4864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "200179438",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003174",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.