Individual provider Active NPI

Kathy M. Shelton-Riek, MSW, ED.S.

  • Clinical Social Worker
  • Salisbury, NC
National Provider Identifier
1316919921
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001524 Issued in NC
Practice address
420 Statesville Blvd
Salisbury, NC 28144-2318
Phone
(704) 639-9889
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 001524 NC Primary

Addresses

Primary practice location

420 Statesville Blvd
Salisbury, NC 28144-2318

Mailing address

PO Box 1986
Salisbury, NC 28145-1986
Phone (704) 639-9889

Other identifiers 2

IdentifierTypeStateIssuer
71657OtherNCBLUE CROSS AND BLUE SHIEL
60-02058MedicaidNC

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
I20070420000490 NC Practitioner - Clinical Social Worker 4688779549 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001524NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jun 23, 2023 Accepting new patients
Family Therapy Institute PastSince Nov 7, 2014 Accepting new patients
Paradigm Health Care Services, LLC PastSince Oct 1, 2007 Accepting new patients

Locations

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316919921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1986",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281451986",
            "telephone_number": "704-639-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 STATESVILLE BLVD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442318",
            "telephone_number": "704-639-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON-RIEK",
        "first_name": "KATHY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "MSW, ED.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "001524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "71657",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60-02058",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.