Individual provider Active NPI

Kim Moses

  • Clinical Social Worker
  • Hampstead, NC
National Provider Identifier
1699488585
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008639 Issued in NC
Practice address
2761 NC Highway 210 E Unit G #205
Hampstead, NC 28443
Phone
(910) 297-1022
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 C008639 NC Primary

Addresses

Primary practice location

2761 NC Highway 210 E Unit G #205
Hampstead, NC 28443

Mailing address

2761 NC Highway 210 E Unit G #205
Hampstead, NC 28443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240904003938 NC Practitioner - Clinical Social Worker 0941740013 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C008639NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Legacy Counseling, PLLC Clinical Current Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince May 7, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

2761 NC Highway 210 E
Ste G
Hampstead, NC 28443
Phone (775) 481-7908

Organizations & group practices 2

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1699488585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 NC HIGHWAY 210 E UNIT G #205",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "28443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 NC HIGHWAY 210 E UNIT G #205",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "28443",
            "telephone_number": "910-297-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.