Individual provider Active NPI

Cherrie Bardot, LCSW-R

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1184870628
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079550 Issued in NY
Practice address
618 Madison Street
Syracuse, NY 13210-2302
Phone
(315) 426-7633
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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 077450 NY
Clinical Social Worker 1041C0700X 079550 NY Primary

Addresses

Primary practice location

618 Madison Street
Syracuse, NY 13210-2302

Mailing address

618 Madison Street
Syracuse, NY 13210-2302
Phone (315) 426-7633

Other identifiers 1

IdentifierTypeStateIssuer
01649605MedicaidNY

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3682/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1184870628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 MADISON STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102302",
            "telephone_number": "315-426-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 MADISON STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102302",
            "telephone_number": "315-426-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDOT",
        "first_name": "CHERRIE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01649605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.