Individual provider Active NPI

Melissa R Pridgen, LCSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1417521253
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012306 Issued in NC
Practice address
2500 Summit Ave
Greensboro, NC 27405-4522
Phone
(336) 621-8800
NPI assigned
May 17, 2021
Last updated
May 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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 C012306 NC Primary

Addresses

Primary practice location

2500 Summit Ave
Greensboro, NC 27405-4522

Mailing address

2889 Waterstone Loop
High Point, NC 27265-2522
Phone (336) 202-6999

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
I20210811002974 NC Practitioner - Clinical Social Worker 6305240482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Practice addresses (Care Compare)

101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C012306NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Jun 21, 2021 Accepting new patients
Eventus Wholehealth, PLLC Clinical CurrentSince Sep 26, 2022 Accepting new patients
Monarch Current Accepting new patients
Monarch CurrentSince Jun 21, 2021 Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

4140 Cherry St
Winston Salem, NC 27105
Phone (336) 306-9620

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1417521253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2889 WATERSTONE LOOP",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272652522",
            "telephone_number": "336-202-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 SUMMIT AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054522",
            "telephone_number": "336-621-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDGEN",
        "first_name": "MELISSA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.