Individual provider Active NPI

Kristin Rose Hammond, LCSW

  • Clinical Social Worker
  • Lillington, NC
National Provider Identifier
1215052436
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
COO3764 Issued in NC
Practice address
1186 N Main St
Lillington, NC 27546-6640
Phone
(910) 814-0909
Fax
(910) 814-0915
NPI assigned
Mar 20, 2007
Last updated
Feb 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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 COO3764 NC Primary

Addresses

Primary practice location

1186 N Main St
Lillington, NC 27546-6640

Mailing address

1186 N Main St
P.O. Box 1921
Lillington, NC 27546-6640
Phone (910) 814-0909

Other identifiers 1

IdentifierTypeStateIssuer
6002861MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
COO3764NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1215052436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 N MAIN ST",
            "address_2": "P.O. BOX 1921",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275466640",
            "telephone_number": "910-814-0909",
            "fax_number": "910-814-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 N MAIN ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275466640",
            "telephone_number": "910-814-0909",
            "fax_number": "910-814-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "KRISTIN",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "COO3764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002861",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.