Individual provider Active NPI

Daniel Shawn Ayers, LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1710098926
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004952 Issued in NC
Practice address
211 E Six Forks Rd
Ste105
Raleigh, NC 27609-7745
Phone
(919) 368-3172
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 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 C004952 NC Primary

Addresses

Primary practice location

211 E Six Forks Rd
Ste105
Raleigh, NC 27609-7745

Mailing address

7833 Melcombe Way
Wake Forest, NC 27587-5325
Phone (919) 556-5787

Other identifiers 3

IdentifierTypeStateIssuer
369322OtherNCMHN
6003399MedicaidNC
140GWOtherNCBLUE CROSS BLUE SHIELD 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

State licenses

LicenseStateTypeSpecialty
C004952NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1710098926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7833 MELCOMBE WAY",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875325",
            "telephone_number": "919-556-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD",
            "address_2": "STE105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097745",
            "telephone_number": "919-368-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYERS",
        "first_name": "DANIEL",
        "middle_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "369322",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003399",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "140GW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.