Individual provider Active NPI

Tammy Bays Rose, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1639388945
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005211 Issued in NC
Practice address
4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone
(919) 237-1337
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 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 C005211 NC Primary

Addresses

Primary practice location

4705 University Dr BLDG 700
Durham, NC 27707-3489

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 237-1337

Other identifiers 1

IdentifierTypeStateIssuer
6106382MedicaidNC

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
I20240217000862 NC Practitioner - Clinical Social Worker 4082681085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

7850 Brier Creek Pkwy
Suite 102
Raleigh, NC 27617-8900
Phone (984) 263-0846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Mar 1, 2024 Accepting new patients

Locations

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

7850 Brier Creek Pkwy
Ste 102
Raleigh, NC 27617
Phone (919) 748-4878

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1639388945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TAMMY",
        "middle_name": "BAYS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106382",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.