Individual provider Active NPI

Jessica Carpenter Knox, MSW, LCSWA

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1326557174
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P010866 Issued in NC
Practice address
3125 Poplarwood CT Ste 300
Raleigh, NC 27604-6445
Phone
(919) 790-8580
NPI assigned
Sep 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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 P010866 NC Primary

Addresses

Primary practice location

3125 Poplarwood CT Ste 300
Raleigh, NC 27604-6445

Mailing address

200 Cherrylaurel Dr
Youngsville, NC 27596-7133
Phone (919) 417-4155

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
I20200319001371 NC Practitioner - Clinical Social Worker 5092143347 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Behavioral Health ServicesGroup PAC ID 5395988133, 6 clinicians

Practice addresses (Care Compare)

104 N Main St
Suite 200
Louisburg, NC 27549-2516
Phone (919) 496-7781

122 W Vernon Ave
Wake Forest, NC 27587-2816
Phone (252) 231-2655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P010866NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Christian Counseling, PLLC CurrentSince Oct 29, 2022 Accepting new patients
Vision Behavioral Health Services CurrentSince Oct 31, 2019 Accepting new patients

Locations

104 N Main St
#200
Louisburg, NC 27549
Phone (919) 496-7781

122 W Vernon Ave
Wake Forest, NC 27587
Phone (252) 231-2655

Organizations & group practices 2

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1326557174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CHERRYLAUREL DR",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "275967133",
            "telephone_number": "919-417-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-790-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "JESSICA",
        "middle_name": "CARPENTER",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.