Active NPI
Vonda B Gardner, MSW, LCSW
- Clinical Social Worker
- Surf City, NC
National Provider Identifier
1669426946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C004100
- Practice address
- 743 Cockle St
Surf City, NC 28445-6511 - Phone
- (910) 231-1986
- NPI assigned
- May 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C004100 | NC | Primary |
Addresses
Primary practice location
743 Cockle St
Surf City, NC 28445-6511
Mailing address
743 Cockle St
Surf City, NC 28445-6511
Phone (910) 231-1986
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6002451 | 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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Self, PLLC | Clinical | Past | Accepting new patients |
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": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1669426946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "743 COCKLE ST",
"city": "SURF CITY",
"state": "NC",
"postal_code": "284456511",
"telephone_number": "910-231-1986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "743 COCKLE ST",
"city": "SURF CITY",
"state": "NC",
"postal_code": "284456511",
"telephone_number": "910-231-1986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "VONDA",
"middle_name": "B",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C004100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6002451",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Surf City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.