Individual provider Active NPI

Miriam Rushton, LCSW

Clinical Social Worker
Charlotte, NC

National Provider Identifier

1144706938

Registry record updated Apr 29, 2025

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Charlotte, NC
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Clinical Social WorkerTaxonomy code 1041C0700X
License: P01059 Issued in NC
Practice address: 4240 West Blvd
Charlotte, NC 28208-6426
Phone: (984) 661-4578
Fax: (855) 300-8471
NPI assigned: Jul 14, 2018
Reactivated: Sep 2, 2021
Last updated: Apr 29, 2025By the provider in NPPES
Sex: Female
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	P01059	NC	Primary

Addresses

Primary practice location

4240 West Blvd
Charlotte, NC 28208-6426

Mailing address

4240 West Blvd
Charlotte, NC 28208-6426
Phone (984) 661-4578

Electronic endpoints 13

Type	Endpoint	Use	Affiliation
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	n/a
Other URL	na
Other URL	n/a
Other URL	na

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled

State licenses

License	State	Type	Specialty
P01059	NC	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Sparc Network	Clinical	Past	Accepting new patients

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.

Sparc Network
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1396155834
Clinical
NPD (past)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1144706938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 WEST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282086426",
            "telephone_number": "984-661-4578",
            "fax_number": "855-300-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 WEST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282086426",
            "telephone_number": "984-661-4578",
            "fax_number": "855-300-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHTON",
        "first_name": "MIRIAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-14",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "deactivation_date": "2020-11-10",
        "reactivation_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P01059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "4240 West Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282086426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.