Active NPI
Carla Bunner
- Clinical Social Worker
- Frederick, MD
National Provider Identifier
1194297085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19141
- Practice address
- 9051 Ridgefield Dr
Frederick, MD 21701-6740 - Phone
- (240) 236-1512
- NPI assigned
- Dec 18, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
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 | 19141 | MD | Primary |
Addresses
Primary practice location
9051 Ridgefield Dr
Frederick, MD 21701-6740
Mailing address
7915 Mount Pleasant CT E
Walkersville, MD 21793-7306
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 541628100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19141 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545091200000",
"number": "1194297085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7915 MOUNT PLEASANT CT E",
"city": "WALKERSVILLE",
"state": "MD",
"postal_code": "217937306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9051 RIDGEFIELD DR",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217016740",
"telephone_number": "240-236-1512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUNNER",
"first_name": "CARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-18",
"last_updated": "2018-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "19141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "541628100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.