Individual provider Active NPI

Quintisha China

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1093379232
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012122 Issued in NC
Practice address
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Phone
(919) 519-5432
NPI assigned
Apr 23, 2019
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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 C012122 NC Primary

Addresses

Primary practice location

2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273

Mailing address

118 Claystone Dr
Gibsonville, NC 27249-2883
Phone (919) 519-5432

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
I20250731002707 NC Practitioner - Clinical Social Worker 0941653224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical of New Jersey PCGroup PAC ID 5799141750, 61 clinicians

Practice addresses (Care Compare)

3064 Wake Forest Rd
Suite 1271
Raleigh, NC 27609-7844
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C012122NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Counseling Ministries Clinical Current Accepting new patients
Brightside Medical of New Jersey, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Ancora Counseling Center, PC Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

2530 Meridian Pkwy
Ste 300
Durham, NC 27713
Phone (919) 443-1708

3064 Wake Forest Rd
Raleigh, NC 27609
Phone (415) 360-3345

Organizations & group practices 3

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1093379232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CLAYSTONE DR",
            "city": "GIBSONVILLE",
            "state": "NC",
            "postal_code": "272492883",
            "telephone_number": "919-519-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 MERIDIAN PKWY STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135273",
            "telephone_number": "919-519-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINA",
        "first_name": "QUINTISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.