Active NPI
Amelia Coonrod
- Clinical Social Worker
- Columbus, NC
National Provider Identifier
1659827202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P010689
- Practice address
- 94 White Dr
Columbus, NC 28722 - Phone
- (828) 894-2290
- NPI assigned
- Sep 1, 2016
- Last updated
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P010689 | NC | Primary |
Addresses
Primary practice location
94 White Dr
Columbus, NC 28722
Mailing address
94 White Dr
Columbus, NC 28722
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P010689 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P010689 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1659827202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 WHITE DR",
"city": "COLUMBUS",
"state": "NC",
"postal_code": "28722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 WHITE DR",
"city": "COLUMBUS",
"state": "NC",
"postal_code": "28722",
"telephone_number": "828-894-2290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COONROD",
"first_name": "AMELIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P010689",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P010689",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.