Individual provider Active NPI

Christa Whorton

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1538714258
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16443 Issued in FL
Practice address
2200 Rosselle St
Jacksonville, FL 32204-3126
Phone
(904) 510-3484
Fax
(954) 337-2844
NPI assigned
Aug 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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 SW16443 FL Primary

Addresses

Primary practice location

2200 Rosselle St
Jacksonville, FL 32204-3126

Mailing address

2200 Rosselle St
Jacksonville, FL 32204-3126
Phone (904) 510-3484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW16443FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
National Youth Advocate Program, Inc CurrentSince Apr 17, 2020 Accepting new patients
Cotler Children and Family Services, LLC Past Accepting new patients

Locations

2200 Rosselle St
Jacksonville, FL 32204
Phone (904) 510-3484

Organizations & group practices 2

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": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1538714258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ROSSELLE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043126",
            "telephone_number": "904-510-3484",
            "fax_number": "954-337-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ROSSELLE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043126",
            "telephone_number": "904-510-3484",
            "fax_number": "954-337-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHORTON",
        "first_name": "CHRISTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.