Jazmon Womack
Individual provider Active NPI Clinical Social Worker · Browns Summit, NC
NPI 1063933539 · NPPES record last updated Sep 27, 2021
Key facts
- NPI
- 1063933539
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C012855 (NC)
- Practice address
- 4229 Yanceyville Rd Apt R
Browns Summit, NC 27214-8003 - Phone
- (336) 280-9796
- NPI assigned
- Jul 5, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orinoco Wellness, LC
Practice addresses (Care Compare)
200 N Main St
Suite 304
Graham, NC 27253-2853
Phone (336) 265-6723
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201007002321 | NC | Practitioner - Clinical Social Worker | 6305265547 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C012855 | NC | MD | Clinical Social Worker |
| P011699 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Opportunities Industrialization Center, Inc. | Current |
Accepting new patients | |
| Little-Gerald Services | Current |
Accepting new patients | |
| Orinoco Wellness, LC | Current |
Accepting new patients | |
| Opportunities Industrialization Center, Inc | Current |
Accepting new patients |
Locations
200 N Main St
Ste 304
Graham, NC 27253
Phone (336) 265-6723
1112 Skyway Dr
Monroe, NC 28110
Phone (704) 283-9055
90 Guardian Ct
Rocky Mount, NC 27804
Phone (252) 212-3350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C012855 | NC | Yes |
| Clinical Social Worker | 1041C0700X | P011699 | NC |
Addresses
Primary practice location
4229 Yanceyville Rd Apt R
Browns Summit, NC 27214-8003
Mailing address
2716 Troxler Rd
Burlington, NC 27215-9187
Phone (336) 570-0104
Other providers in Browns Summit, NC
- Karen Elizabeth Wallace
- Wescare Professional Services, LLC.
- Felicia Williams-Cobbs
- Crystal Dawn Williamson
- Without Borders Collective PLLC
- Ashley Woods
- Lee Melvin Woodson Jr.
- Youth Focus
- Glen Zelenak
All providers in Browns Summit, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.