Individual provider Active NPI

Rebecca Anne Kyle, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1417566613
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011201 Issued in NC
Practice address
311 W Main St Ste 408
Durham, NC 27701-3215
Phone
(919) 205-8057
NPI assigned
Jul 24, 2020
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 C011201 NC Primary

Addresses

Primary practice location

311 W Main St Ste 408
Durham, NC 27701-3215

Mailing address

5901 Scalybark Rd
Durham, NC 27712-1264
Phone (803) 767-5116

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
I20200805000101 NC Practitioner - Clinical Social Worker 1153746318 Reassigns benefits to 1 organization
Practice locations: Durham, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

331 W Main St
Suite 408
Durham, NC 27701-0108
Phone (919) 205-8057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Current Accepting new patients

Locations

3024 Pickett Rd
Durham, NC 27705
Phone (919) 490-9800

3004 Tower Blvd
Durham, NC 27707
Phone (919) 236-1882

Organizations & group practices 1

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": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1417566613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 SCALYBARK RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277121264",
            "telephone_number": "803-767-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W MAIN ST STE 408",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013215",
            "telephone_number": "919-205-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.