Active NPI
Mary Barclay Grammer, LCSW
- Clinical Social Worker
- Pocahontas, TN
National Provider Identifier
1336157346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3180
- Practice address
- 248 Dan Head Road
Pocahontas, TN 38061-4220 - Phone
- (731) 646-0065
- Fax
- (731) 646-0071
- NPI assigned
- Aug 4, 2006
- Last updated
- Nov 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | C5803 | MS | |
| Clinical Social Worker | 1041C0700X | 3180 | TN | Primary |
Addresses
Primary practice location
248 Dan Head Road
Pocahontas, TN 38061-4220
Mailing address
248 Dan Head Road
Pocahontas, TN 38061-4220
Phone (731) 646-0065
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3155253 | Other | TN | BCBS |
| 2040477 | Other | TN | CIGNA |
| G00678588 | Medicaid | MS | |
| 7241190 | Other | TN | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5803 | MS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1336157346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 DAN HEAD ROAD",
"city": "POCAHONTAS",
"state": "TN",
"postal_code": "380614220",
"telephone_number": "731-646-0065",
"fax_number": "731-646-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 DAN HEAD ROAD",
"city": "POCAHONTAS",
"state": "TN",
"postal_code": "380614220",
"telephone_number": "731-646-0065",
"fax_number": "731-646-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAMMER",
"first_name": "MARY",
"middle_name": "BARCLAY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MS",
"license": "C5803",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "3180",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "3155253",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2040477",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G00678588",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7241190",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.