Individual provider Active NPI

John C Carter, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1053624098
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014243 Issued in IL
Practice address
53 W Jackson Blvd
1257
Chicago, IL 60604-3606
Phone
(312) 360-1983
Fax
(312) 360-1984
NPI assigned
Jul 20, 2010
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 149014243 IL Primary

Addresses

Primary practice location

53 W Jackson Blvd
1257
Chicago, IL 60604-3606

Mailing address

53 W Jackson Blvd
1257
Chicago, IL 60604-3606
Phone (312) 360-1983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110429000529 IL Practitioner - Clinical Social Worker 0840475182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piven & Smith PLLC Clinical CurrentSince May 26, 2024 Accepting new patients
Blackett & Smith PLLC Clinical CurrentSince Feb 12, 2023 Accepting new patients

Locations

53 W Jackson Blvd
Chicago, IL 60604
Phone (312) 786-1419

53 W Jackson Blvd
Ste 1160
Chicago, IL 60604

53 W Jackson Blvd
Ste 1257
Chicago, IL 60604
Phone (312) 360-1983

53 W Jackson Blvd
Ste 1415
Chicago, IL 60604
Phone (312) 360-1983

750 N Saint Paul St
Ste 605
Dallas, TX 75201
Phone (214) 864-1792

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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1053624098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD",
            "address_2": "1257",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043606",
            "telephone_number": "312-360-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD",
            "address_2": "1257",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043606",
            "telephone_number": "312-360-1983",
            "fax_number": "312-360-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.