Individual provider Active NPI

Sandra Marie Sargent

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1184948523
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006578 Issued in NC
Practice address
311 Judges Rd Ste 4E
Wilmington, NC 28405-3655
Phone
(910) 791-6767
Fax
(910) 791-6890
NPI assigned
Mar 14, 2010
Last updated
May 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2010

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 C006578 NC Primary

Addresses

Primary practice location

311 Judges Rd Ste 4E
Wilmington, NC 28405-3655

Mailing address

PO Box 696
Hampstead, NC 28443-0696
Phone (910) 791-6767

Other identifiers 1

IdentifierTypeStateIssuer
157JCOtherNCBCBS NC

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
I20100329000785 NC Practitioner - Clinical Social Worker 2961538913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Verna Dority MSW CCSW IncGroup PAC ID 6709070527, 19 clinicians

Practice addresses (Care Compare)

35 Plantation Dr
Suite 100B
Cameron, NC 28326-9430
Phone (919) 895-3222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C006578NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Verna Dority, MSW, CCSW, Inc Clinical CurrentSince Jun 10, 2021 Accepting new patients

Locations

35 Plantation Dr
Ste 100B
Cameron, NC 28326
Phone (346) 327-6070

602 E Academy St
Ste 103
Fuquay Varina, NC 27526
Phone (910) 762-3185

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": "1268524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1184948523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284430696",
            "telephone_number": "910-791-6767",
            "fax_number": "910-791-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 JUDGES RD STE 4E",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053655",
            "telephone_number": "910-791-6767",
            "fax_number": "910-791-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-14",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "157JC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.