Yvette Evans Fairley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007936 Issued in GA

Practice address

200 Gordon Ave
Thomasville, GA 31792-6640

Phone

(786) 203-4268

NPI assigned

Apr 6, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Yvette Evans Fairley Professional name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Clinical Social Worker

Education

Florida State University College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John D Archbold Memorial Hospital IncGroup PAC ID 4981502622, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• John D Archbold Memorial Hospital Inc

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702

  GA

  Medicare reassignment Care Compare group NPD
• Pathology Associates, P.C.

  • Anatomic Pathology Physician
  • Thomasville, GA
  • NPI 1417910043
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John D Archbold Memorial Hospital Inc

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702

  Hospital

  Care Compare affiliation
• John D. Archbold Memorial Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Thomasville, GA
  • NPI 1104867738

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1700527264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7075",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317587075",
            "telephone_number": "786-203-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926640",
            "telephone_number": "786-203-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS FAIRLEY",
        "first_name": "YVETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVETTE",
            "last_name": "EVANS FAIRLEY",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• ENT Associates of South West Ga
• Nsikan D Essien
• Gabriel Estevez, MD
• Lisa Eubanks
• Henry Alamzan Eugenio, M.D.
• Ana Grace Evans, CCC-SLP
• Jill Bloodworth Everett, CCC SLP
• Moses D Everett Jr.
• Richard Crampah Ewoodzie, MD
• James W Falconer

• All providers in Thomasville, GA
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.