Individual provider Active NPI

Patricia Whatley Showelll, LCSW

  • Clinical Social Worker
  • Conyers, GA
National Provider Identifier
1265798953
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW000998 Issued in GA
Practice address
977A Taylor St SW
Conyers, GA 30012-5357
Phone
(770) 918-6677
NPI assigned
Apr 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 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 CSW000998 GA Primary

Addresses

Primary practice location

977A Taylor St SW
Conyers, GA 30012-5357

Mailing address

977A Taylor St SW
Conyers, GA 30012-5357
Phone (770) 918-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20120919000745 GA Practitioner - Clinical Social Worker 2567527187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
View Point HealthGroup PAC ID 0840272282, 33 clinicians

Practice addresses (Care Compare)

175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone (770) 339-5071

977 Taylor SWST a
Conyers, GA 30012-5357
Phone (770) 918-6677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW000998GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
View Point Health CurrentSince Jul 7, 2012 Accepting new patients

Locations

977 Taylor St SW
#A
Conyers, GA 30012
Phone (770) 785-5910

977A Taylor St SW
Conyers, GA 30012
Phone (770) 918-6677

175 Gwinnett Dr
Lawrenceville, GA 30046
Phone (678) 209-2394

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.

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1265798953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977A TAYLOR ST SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125357",
            "telephone_number": "770-918-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977A TAYLOR ST SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125357",
            "telephone_number": "770-918-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWELLL",
        "first_name": "PATRICIA",
        "middle_name": "WHATLEY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW000998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.