Individual provider Active NPI

Cheryl Harmon Maddux, LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1699768788
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004823 Issued in NC
Practice address
1606 Physicians Dr
Suite 104
Wilmington, NC 28401-7361
Phone
(910) 343-6890
Fax
(910) 332-1233
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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 C004823 NC Primary

Addresses

Primary practice location

1606 Physicians Dr
Suite 104
Wilmington, NC 28401-7361

Mailing address

34 Central Blvd
Wilmington, NC 28401-6945
Phone (910) 471-6516

Other identifiers 3

IdentifierTypeStateIssuer
B0318OtherMEDCOST
0238MOtherBCBS
6005107MedicaidNC

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
I20050224000407 NC Practitioner - Clinical Social Worker 5092768580 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1606 Physicians Dr
Suite 104
Wilmington, NC 28401-7348
Phone (910) 343-6890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1699768788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CENTRAL BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016945",
            "telephone_number": "910-471-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 PHYSICIANS DR",
            "address_2": "SUITE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017361",
            "telephone_number": "910-343-6890",
            "fax_number": "910-332-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDUX",
        "first_name": "CHERYL",
        "middle_name": "HARMON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B0318",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0238M",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005107",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.