NPIMap

Individual provider Active NPI

Emily Peterson

  • Clinical Social Worker
  • Concord, NC
National Provider Identifier
1194109538
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010924 Issued in NC
Practice address
101 Cabarrus Ave E
Concord, NC 28025-3699
Phone
(888) 849-7379
Fax
(855) 857-7333
NPI assigned
Jul 15, 2015
Last updated
Apr 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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 C010924 NC Primary

Addresses

Primary practice location

101 Cabarrus Ave E
Concord, NC 28025-3699

Mailing address

101 Cabarrus Ave E
Concord, NC 28025-3699
Phone (888) 849-7379

Other practice location 1

6030 Old Orchard Rd
Kernersville, NC 27284-8095
Phone (978) 500-3351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414001459 NC Practitioner - Clinical Social Worker 1951609528 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

444 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0421

460 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0951

7029 Albert Pick Rd
Suite 200
Greensboro, NC 27409-9521
Phone (919) 972-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated Clinical Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Jul 1, 2025 Accepting new patients
Goshen Medical Center Incorporated CurrentSince Jul 1, 2025 Accepting new patients
Optum Behavioral Care of North Carolina, PC CurrentSince Oct 25, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Clinical CurrentSince Oct 25, 2024 Accepting new patients
Goshen Medical Center, Incorporated Current Accepting new patients
Carelink Solutions CurrentSince Jan 17, 2016 Accepting new patients
Carelink Solutions PastSince Jan 17, 2016 Accepting new patients
Psychological Healthcare, PLLC Past Accepting new patients

Locations

1101 Marco Dr
Ste 200
Apex, NC 27502
Phone (844) 534-7202

7400 Carmel Executive Park Dr
Ste 155
Charlotte, NC 28226
Phone (844) 534-7208

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

104 Adair Dr
#A
Goldsboro, NC 27530
Phone (919) 648-4435

1214 Grove St
Greensboro, NC 27403
Phone (336) 285-6887

7029 Albert Pick Rd
Ste 200
Greensboro, NC 27409
Phone (704) 885-0268

Interoperability endpoints

  • Direct secure messaging: epeterson@goshenmedical.cloudcraftdirect.com

Organizations & group practices 10

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1194109538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6030 Old Orchard Rd",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272848095",
            "country_code": "US",
            "telephone_number": "978-500-3351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.