Individual provider Active NPI

Chris Digiandomenico, LMSW

  • Social Worker
  • Summerville, SC
National Provider Identifier
1487852174
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5709 Issued in SC
Practice address
500 N Main St
Suite4
Summerville, SC 29483-6439
Phone
(843) 871-4790
Fax
(843) 871-8579
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 5709 SC
Mental Health Counselor 101YM0800X 5709 SC
Social Worker 104100000X 5709 SC Primary

Addresses

Primary practice location

500 N Main St
Suite4
Summerville, SC 29483-6439

Mailing address

500 N Main St
Suite4
Summerville, SC 29483-6439
Phone (843) 871-4790

Other identifiers 1

IdentifierTypeStateIssuer
AD16DOMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5709SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1487852174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST",
            "address_2": "SUITE4",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836439",
            "telephone_number": "843-871-4790",
            "fax_number": "843-871-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST",
            "address_2": "SUITE4",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836439",
            "telephone_number": "843-871-4790",
            "fax_number": "843-871-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIANDOMENICO",
        "first_name": "CHRIS",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "5709",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "5709",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "5709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AD16DO",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.