Individual provider Active NPI

Carrie Spake Patterson, LCSW

  • Clinical Social Worker
  • Cordova, TN
National Provider Identifier
1477658441
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000003073 Issued in TN
Practice address
243 Germantown Bend CV Ste 101
Cordova, TN 38018-4251
Phone
(901) 761-9178
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 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 LSW0000003073 TN Primary

Addresses

Primary practice location

243 Germantown Bend CV Ste 101
Cordova, TN 38018-4251

Mailing address

243 Germantown Bend CV Ste 101
Cordova, TN 38018-4251
Phone (901) 761-9178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040116001064 TN Practitioner - Clinical Social Worker 0042111536 Practice locations: Cordova, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

243 Germantown Bend CV
Suite 101
Cordova, TN 38018-4251
Phone (901) 340-0773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW0000003073TNMDClinical Social Worker
3073TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Solutions, Inc. Past Accepting new patients

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1477658441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 GERMANTOWN BEND CV STE 101",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184251",
            "telephone_number": "901-761-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GERMANTOWN BEND CV STE 101",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184251",
            "telephone_number": "901-761-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "CARRIE",
        "middle_name": "SPAKE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000003073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.