Individual provider Active NPI

Donna Rae Bartlett, MSW LCSW CMHT

  • Social Worker
  • Raleigh, NC
National Provider Identifier
1538185772
Registry record updated May 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
C004214 Issued in NC
Practice address
621 S Lakeside Dr
Raleigh, NC 27606-2233
Phone
(919) 412-8046
Fax
(919) 859-2780
NPI assigned
Jul 14, 2006
Last updated
May 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X C004214 NC Primary

Addresses

Primary practice location

621 S Lakeside Dr
Raleigh, NC 27606-2233

Mailing address

621 S Lakeside Dr
Raleigh, NC 27606-2233
Phone (919) 412-8046

Other identifiers 2

IdentifierTypeStateIssuer
133UKOtherNCBLUE CROSS BLUE SHIELD
6106251MedicaidNC

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
I20070227000799 NC Practitioner - Clinical Social Worker 9830291459 Practice locations: Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

621 S Lakeside Dr
Raleigh, NC 27606-2233
Phone (919) 412-8046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C004214NCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindpath Care Centers, North Carolina, PLLC PastSince Aug 15, 2004 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, 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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275177600000",
    "number": "1538185772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S LAKESIDE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062233",
            "telephone_number": "919-412-8046",
            "fax_number": "919-859-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S LAKESIDE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062233",
            "telephone_number": "919-412-8046",
            "fax_number": "919-859-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "DONNA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "MSW LCSW CMHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C004214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "133UK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106251",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.