Individual provider Active NPI

Kendra K Moree, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1386975597
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P004566 Issued in NC
Practice address
2300 Randolph Rd
Charlotte, NC 28207-1562
Phone
(704) 347-4144
Fax
(704) 347-4148
NPI assigned
Jan 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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 P004566 NC Primary

Addresses

Primary practice location

2300 Randolph Rd
Charlotte, NC 28207-1562

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

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
I20100823000999 NC Practitioner - Clinical Social Worker 1052435344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5513 Monroe Rd
Suite 202
Charlotte, NC 28212-5503
Phone (704) 562-3095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P004566NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Therapy Specialists, PLLC Clinical CurrentSince Oct 7, 2015 Accepting new patients
Carolinas Medical Center Past Accepting new patients

Locations

100 Greenwich Rd
NC 28211

5513 Monroe Rd
Ste 202
Charlotte, NC 28212
Phone (704) 562-3095

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": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1386975597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071562",
            "telephone_number": "704-347-4144",
            "fax_number": "704-347-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREE",
        "first_name": "KENDRA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-28",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P004566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.