Individual provider Active NPI

Sharon Keyes, L.C.S.W.

  • Clinical Social Worker
  • Green Mountain, NC
National Provider Identifier
1114229101
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004848 Issued in NC
Practice address
8851 Jacks Creek Rd
Green Mountain, NC 28740-8802
Phone
(828) 678-3408
NPI assigned
Nov 23, 2010
Last updated
Nov 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C004848 NC Primary
Clinical Social Worker 1041C0700X 21824 CA

Addresses

Primary practice location

8851 Jacks Creek Rd
Green Mountain, NC 28740-8802

Mailing address

8851 Jacks Creek Rd
Green Mountain, NC 28740-8802
Phone (828) 678-3408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191014002405 CA Practitioner - Clinical Social Worker 8729027495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1317 Oakdale Rd
Suite 100
Modesto, CA 95355-3362
Phone (209) 522-3362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C004848NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Medical Care a Professional Corporation CurrentSince Sep 1, 2019 Accepting new patients
Family First Medical Care a Professional Corporation CurrentSince Sep 1, 2019 Accepting new patients
Hospice & Palliative Care of the Blue Ridge Inc PastSince Jul 31, 2017 Accepting new patients
New Vistas-Mountain Laurel, Inc. Clinical Past Accepting new patients

Locations

1317 Oakdale Rd
Ste 100
Modesto, CA 95355
Phone (209) 522-3362

1317 Oakdale Rd
Ste 440
Modesto, CA 95355
Phone (209) 522-3362

Organizations & group practices 4

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": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1114229101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 JACKS CREEK RD",
            "city": "GREEN MOUNTAIN",
            "state": "NC",
            "postal_code": "287408802",
            "telephone_number": "828-678-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 JACKS CREEK RD",
            "city": "GREEN MOUNTAIN",
            "state": "NC",
            "postal_code": "287408802",
            "telephone_number": "828-678-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYES",
        "first_name": "SHARON",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004848",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Mountain, NC

Sources for this page

Verify at the official NPI Registry.