Individual provider Active NPI

Charles Lawrence Pope, LCSW

  • Clinical Social Worker
  • Herkimer, NY
National Provider Identifier
1639473754
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086166 Issued in NY
Practice address
321 E Albany St
Herkimer, NY 13350-2016
Phone
(315) 867-2700
NPI assigned
Jan 4, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 086166 NY Primary

Addresses

Primary practice location

321 E Albany St
Herkimer, NY 13350-2016

Mailing address

321 E Albany St
Herkimer, NY 13350-2016
Phone (315) 867-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20171201002722 NY Practitioner - Clinical Social Worker 8729345574 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Herkimer CountyGroup PAC ID 4284613779, 11 clinicians

Practice addresses (Care Compare)

301 N Washington St
Suite 2470
Herkimer, NY 13350-1299
Phone (315) 867-1465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086166NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Apr 7, 2020 Accepting new patients
Upstate Cerebral Palsy, Inc Single Specialty CurrentSince Oct 23, 2017 Accepting new patients
Herkimer County Single Specialty CurrentSince Mar 15, 2021 Accepting new patients
Mary Imogene Bassett Hospital Single Specialty CurrentSince Apr 7, 2020 Accepting new patients
Herkimer County CurrentSince Mar 15, 2021 Accepting new patients
Upstate Cerebral Palsy, Inc. CurrentSince Oct 23, 2017 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

301 N Washington St
Ste 2470
Herkimer, NY 13350
Phone (315) 867-1465

321 E Albany St
Herkimer, NY 13350
Phone (315) 867-2700

125 Business Park Dr
Utica, NY 13502
Phone (315) 724-6907

1601 Armory Dr
Utica, NY 13501
Phone (315) 798-4006

1427 Genesee St
Utica, NY 13501
Phone (315) 738-1428

Organizations & group practices 6

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": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1639473754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E ALBANY ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502016",
            "telephone_number": "315-867-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E ALBANY ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502016",
            "telephone_number": "315-867-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "CHARLES",
        "middle_name": "LAWRENCE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-04",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herkimer, NY

Sources for this page

Verify at the official NPI Registry.