Individual provider Active NPI

Sheila Moore-Bunch, LCSW

  • Clinical Social Worker
  • Sparks, NV
National Provider Identifier
1275765083
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2286-C Issued in NV
Practice address
480 Galletti Way
Sparks, NV 89431-5564
Phone
(775) 688-2001
Fax
(775) 688-2004
NPI assigned
Aug 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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 2286-C NV Primary

Addresses

Primary practice location

480 Galletti Way
Sparks, NV 89431-5564

Mailing address

480 Galletti Way
Sparks, NV 89431-5564
Phone (775) 688-2001

Other identifiers 1

IdentifierTypeStateIssuer
2286-COtherNVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230223002043 TX Practitioner - Clinical Social Worker 9133253396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

1411 Medical Pkwy
Suite 201
Cedar Park, TX 78613-2696
Phone (888) 374-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2286-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Oct 7, 2024 Accepting new patients
Family Care Center LLC, CurrentSince Oct 7, 2024 Accepting new patients

Locations

1411 Medical Pkwy
Ste 201
Cedar Park, TX 78613
Phone (254) 715-8443

551 S Interstate 35
Ste 200
Round Rock, TX 78664
Phone (512) 241-7314

Organizations & group practices 3

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": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1275765083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-2001",
            "fax_number": "775-688-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-2001",
            "fax_number": "775-688-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-BUNCH",
        "first_name": "SHEILA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "2286-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2286-C",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.