Individual provider Active NPI

Sandra S Quarles, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1538243241
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904000159 Issued in VA
Practice address
309 Lynnhaven Pkwy Ste 100
Virginia Beach, VA 23452-7411
Phone
(757) 385-2132
Fax
(757) 427-2480
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 0904000159 VA Primary

Addresses

Primary practice location

309 Lynnhaven Pkwy Ste 100
Virginia Beach, VA 23452-7411

Mailing address

221A 63Rd St
Virginia Beach, VA 23451-2124
Phone (757) 270-9170

Other identifiers 6

IdentifierTypeStateIssuer
004945395MedicaidVA
081144MOtherVASENTARA
CO3533OtherVAMCR GROUP
174570OtherVAANTHEM
174570OtherVAHKP
004945395OtherVAVA PREMIER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040122000860 VA Practitioner - Clinical Social Worker 7517869324 Practice locations: Virginia Beach, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1971
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2940 N Lynnhaven Rd
Suite 110
Virginia Beach, VA 23452-6949
Phone (757) 270-9170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904000159VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
City of Virginia Beach Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9229a1fd-2cd1-41dc-9da8-258046291286/

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1538243241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221A 63RD ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234512124",
            "telephone_number": "757-270-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 LYNNHAVEN PKWY STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527411",
            "telephone_number": "757-385-2132",
            "fax_number": "757-427-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARLES",
        "first_name": "SANDRA",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945395",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "081144M",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR GROUP",
            "identifier": "CO3533",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "174570",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HKP",
            "identifier": "174570",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "004945395",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.