Donald R Clise II, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

C008971 Issued in NC

Practice address

7825 Ballantyne Commons Pkwy
Ste 110
Charlotte, NC 28277-3174

Phone

(704) 446-0391

NPI assigned

Sep 15, 2011

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 2

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ambulatory@direct.carolinashealthcare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment Care Compare group NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Addiction Services Ballantyne

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
  • NPI 1124593470
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1285916155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 BALLANTYNE COMMONS PKWY",
            "address_2": "STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773174",
            "telephone_number": "704-446-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLISE",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_suffix": "II",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "C008971",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C008971",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "7825 Ballantyne Commons Pkwy",
            "address_2": "Ste 110",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282773174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karrisa Clinkscales
• Tomeka Latonya Clinkscales, FNP
• Clinworks, Inc.
• Clio Laboratory, LLC
• Jean L. Caroline Clippard
• Jessica Clodfelter, MS, LCMHC, NCC
• Timothy E Cloninger, M.D.
• Nichole Lowery Clontz, AGNP
• Ted Clontz, M.D.
• Carey-Walter Franklin Closson, MD

• Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.