Individual provider Active NPI

Kristin Baysek Vernon, MSW, LCSW

  • Clinical Social Worker
  • Sanford, NC
National Provider Identifier
1679834485
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P005280 Issued in NC
Practice address
138 S Steele St
2ND Floor
Sanford, NC 27330-4201
Phone
(919) 776-0303
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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 P005280 NC Primary

Addresses

Primary practice location

138 S Steele St
2ND Floor
Sanford, NC 27330-4201

Mailing address

138 S Steele St
2ND Floor
Sanford, NC 27330-4201
Phone (919) 776-0303

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P005280NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Verna Dority, MSW, CCSW, Inc Clinical CurrentSince Oct 27, 2014 Accepting new patients

Locations

6321 Raeford Rd
Fayetteville, NC 28304
Phone (910) 644-0051

602 E Academy St
Ste 103
Fuquay Varina, NC 27526
Phone (910) 762-3185

110 Applecross Rd
Ste A2
Pinehurst, NC 28374
Phone (910) 420-3600

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1679834485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S STEELE ST",
            "address_2": "2ND FLOOR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304201",
            "telephone_number": "919-776-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S STEELE ST",
            "address_2": "2ND FLOOR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304201",
            "telephone_number": "919-776-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "KRISTIN",
        "middle_name": "BAYSEK",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P005280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.