Individual provider Active NPI

Susan Kroll-Smith, LCSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1073667655
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004300 Issued in NC
Practice address
3707 D West Market St
Greensboro, NC 27403-1399
Phone
(336) 312-1804
Fax
(336) 323-1615
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 C004300 NC Primary

Addresses

Primary practice location

3707 D West Market St
Greensboro, NC 27403-1399

Mailing address

3707 D West Market St
Greensboro, NC 27403-1399
Phone (336) 312-1804

Other identifiers 2

IdentifierTypeStateIssuer
133MEOtherNCNC BCBS
6002634MedicaidNC

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
I20101025000622 NC Practitioner - Clinical Social Worker 6709079536 Practice locations: Greensboro, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3707 D W Market St
Greensboro, NC 27403-1399

3707 W Market St D
Greensboro, NC 27403-1399
Phone (336) 312-1804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C004300NCMDClinical Social Worker
3191LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cathy Showfety Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8957/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1073667655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 D WEST MARKET ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031399",
            "telephone_number": "336-312-1804",
            "fax_number": "336-323-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 D WEST MARKET ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031399",
            "telephone_number": "336-312-1804",
            "fax_number": "336-323-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL-SMITH",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BCBS",
            "identifier": "133ME",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002634",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.