Active NPI
Johnisha Watlington
- Clinical Social Worker
- Greensboro, NC
National Provider Identifier
1205474368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P013067
- Practice address
- 3409 W Wendover Ave Ste I
Greensboro, NC 27407-1579 - Phone
- (336) 897-2375
- NPI assigned
- Dec 19, 2019
- 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 | P013067 | NC | Primary |
Addresses
Primary practice location
3409 W Wendover Ave Ste I
Greensboro, NC 27407-1579
Mailing address
612 Pasteur Dr Ste 108
Greensboro, NC 27403-1120
Phone (336) 343-7327
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P013067 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
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Phone (503) 571-2946
2400 Lancaster Dr NE
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Phone (503) 361-5400
14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001
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 and National Provider Directory roles.
-
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- Portland, OR
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1205474368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 PASTEUR DR STE 108",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031120",
"telephone_number": "336-343-7327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3409 W WENDOVER AVE STE I",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274071579",
"telephone_number": "336-897-2375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATLINGTON",
"first_name": "JOHNISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-19",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P013067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.