Individual provider Active NPI

Kerstin Sheets

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1245623396
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P009195 Issued in NC
Practice address
302 Bradford Ave
Fayetteville, NC 28301-5406
Phone
(910) 484-0095
Fax
(919) 238-7287
NPI assigned
Mar 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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 P009195 NC Primary

Addresses

Primary practice location

302 Bradford Ave
Fayetteville, NC 28301-5406

Mailing address

302 Bradford Ave
Fayetteville, NC 28301-5406
Phone (910) 484-0095

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

LicenseStateTypeSpecialty
P009195NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1245623396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BRADFORD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015406",
            "telephone_number": "910-484-0095",
            "fax_number": "919-238-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BRADFORD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015406",
            "telephone_number": "910-484-0095",
            "fax_number": "919-238-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEETS",
        "first_name": "KERSTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P009195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.