Active NPI
Tania Polidor Yarber
- Clinical Social Worker
- Greensboro, NC
National Provider Identifier
1659741346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C011177
- Practice address
- 1007 Summit Ave
Greensboro, NC 27405-7007 - Phone
- (336) 200-7010
- Fax
- (704) 710-8592
- NPI assigned
- Oct 7, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P009991 | NC | |
| Clinical Social Worker | 1041C0700X | C011177 | NC | Primary |
Addresses
Primary practice location
1007 Summit Ave
Greensboro, NC 27405-7007
Mailing address
PO Box 746724
Atlanta, GA 30374-6724
Phone (312) 733-9730
Other practice location 1
405 NC-65
Reidsville, NC 27320
Phone (336) 342-8316
Other names 1
- Gepernard Tania Polidor
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C011177 | NC | MD | Clinical Social Worker |
| P009991 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609804800000",
"number": "1659741346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746724",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746724",
"telephone_number": "312-733-9730",
"fax_number": "312-929-0373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 SUMMIT AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274057007",
"telephone_number": "336-200-7010",
"fax_number": "704-710-8592"
}
],
"practiceLocations": [
{
"address_1": "405 NC-65",
"address_purpose": "LOCATION",
"city": "Reidsville",
"state": "NC",
"postal_code": "27320",
"country_code": "US",
"telephone_number": "336-342-8316",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLIDOR YARBER",
"first_name": "TANIA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-07",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P009991",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C011177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GEPERNARD",
"last_name": "POLIDOR",
"middle_name": "TANIA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.