Individual provider Active NPI

James Rashad Parker Jr., LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1215320700
Registry record updated Feb 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P009326 Issued in NC
Practice address
705 Cumberland St
Fayetteville, NC 28301-7020
Phone
(910) 723-6662
NPI assigned
Mar 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2024

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 P009326 NC Primary

Addresses

Primary practice location

705 Cumberland St
Fayetteville, NC 28301-7020

Mailing address

114 Brainerd Ave
Fayetteville, NC 28301-3870
Phone (910) 723-6662

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
I20190724001534 NC Practitioner - Clinical Social Worker 9739415001 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P009326NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Image Healthcare, Corp CurrentSince Apr 23, 2019 Accepting new patients
Carter Clinic, P.a. PastSince Aug 25, 2019 Accepting new patients
Carter Clinic, P.a. PastSince Mar 4, 2021 Accepting new patients
Carter Clinic, P a Clinical Past Accepting new patients
Carter Clinic, PA Past Accepting new patients

Locations

401 Robeson St
Fayetteville, NC 28301
Phone (910) 321-0069

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1215320700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BRAINERD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013870",
            "telephone_number": "910-723-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 CUMBERLAND ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017020",
            "telephone_number": "910-723-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JAMES",
        "middle_name": "RASHAD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2024-02-11",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P009326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.