Individual provider Active NPI

Dawn Neely

  • Clinical Social Worker
  • Morgantown, WV
National Provider Identifier
1053571893
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BP00941909 Issued in WV
Practice address
874 Fairmont Rd Ste C
Morgantown, WV 26501-3893
Phone
(304) 290-8138
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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 BP00941909 WV Primary

Addresses

Primary practice location

874 Fairmont Rd Ste C
Morgantown, WV 26501-3893

Mailing address

874 Fairmont Rd Ste C
Morgantown, WV 26501-3893
Phone (304) 290-8138

Other names 1

  • Dawn Mortimer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20120111000621 WV Practitioner - Clinical Social Worker 9133396369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
West Virginia University School of Medicine, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

874 Fairmont Rd
Suite C
Morgantown, WV 26501-3893
Phone (304) 381-2456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BP00941909WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Melanie B Rogers LLC PastSince Jun 21, 2016 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, 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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1053571893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 FAIRMONT RD STE C",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265013893",
            "telephone_number": "304-290-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 FAIRMONT RD STE C",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265013893",
            "telephone_number": "304-290-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELY",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "BP00941909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "MORTIMER",
            "credential": "LGSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.