Individual provider Active NPI

Samantha Culler, LCSW-A

  • Clinical Social Worker
  • High Point, NC
National Provider Identifier
1497105407
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P010495 Issued in NC
Practice address
1208 Eastchester Dr
Ste 107
High Point, NC 27265-3170
Phone
(336) 802-2900
Fax
(336) 802-2901
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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 P010495 NC Primary

Addresses

Primary practice location

1208 Eastchester Dr
Ste 107
High Point, NC 27265-3170

Mailing address

PO Box 603086
Charlotte, NC 28260-3086
Phone (336) 802-2000

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
I20160908002388 NC Practitioner - Clinical Social Worker 5193011658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Carolina at Chapel Hill School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Jul 11, 2016 Accepting new patients
Wake Forest Health Network LLC CurrentSince Jul 11, 2016 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest University Health Sciences CurrentSince Apr 1, 2018 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

1208 Eastchester Dr
Ste 107
High Point, NC 27265
Phone (336) 802-2588

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 5

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1497105407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603086",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603086",
            "telephone_number": "336-802-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 EASTCHESTER DR",
            "address_2": "STE 107",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272653170",
            "telephone_number": "336-802-2900",
            "fax_number": "336-802-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLER",
        "first_name": "SAMANTHA",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.