Individual provider Active NPI

Kristin Wodarczyk Melvin

  • Clinical Social Worker
  • Concord, NC
National Provider Identifier
1447720156
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013651 Issued in NC
Practice address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone
(704) 939-1100
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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 C013651 NC Primary

Addresses

Primary practice location

284 Executive Park Dr Ste 100
Concord, NC 28025-1833

Mailing address

284 Executive Park Dr
Concord, NC 28025-1831
Phone (704) 939-1100

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
I20210329000422 NC Practitioner - Clinical Social Worker 4385051911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daymark Recovery Services IncGroup PAC ID 0547233975, 132 clinicians

Practice addresses (Care Compare)

284 Executive Park Dr
Suite 100
Concord, NC 28025-1833
Phone (704) 939-1100

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as group
Quality
89.03
Promoting interoperability
82
Improvement activities
40
Cost
90.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Clinical CurrentSince Jan 21, 2021 Accepting new patients

Locations

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

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

1408 E Franklin St
Monroe, NC 28112
Phone (704) 283-6040

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1447720156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251831",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "KRISTIN",
        "middle_name": "WODARCZYK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.