Individual provider Active NPI

Billy R West Jr., L.C.S.W.

  • Clinical Social Worker
  • Kannapolis, NC
National Provider Identifier
1376622175
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004170 Issued in NC
Practice address
1305 S Cannon Blvd
Kannapolis, NC 28083-6232
Phone
(704) 939-1100
Fax
(704) 939-1173
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 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 C004170 NC Primary

Addresses

Primary practice location

1305 S Cannon Blvd
Kannapolis, NC 28083-6232

Mailing address

1305 S Cannon Blvd
Kannapolis, NC 28083-6232

Other identifiers 1

IdentifierTypeStateIssuer
6106626MedicaidNC

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
I20070707000042 NC Practitioner - Clinical Social Worker 7911970629 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4170NCMDClinical Psychologist
C004170NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Clinical CurrentSince Aug 20, 2004 Accepting new patients
Daymark Recovery Services Inc Past Accepting new patients

Locations

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1305 S Cannon Blvd
Kannapolis, NC 28083
Phone (704) 933-3212

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

1807 E Innes St
Salisbury, NC 28146
Phone (704) 633-3616

Interoperability endpoints

  • Direct secure messaging: billy.west.p1@direct.daymarkrecovery.nextgenshare.com

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1376622175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S CANNON BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S CANNON BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836232",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "BILLY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106626",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

Verify at the official NPI Registry.