Individual provider Active NPI

Niome Krauskopf, MSW

  • Clinical Social Worker
  • Wake Forest, NC
National Provider Identifier
1710141841
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009888 Issued in NC
Practice address
10580 Ligon Mill Rd
Suite 210
Wake Forest, NC 27587-6090
Phone
(919) 263-9592
Fax
(919) 263-9670
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ISW4885 FL
Clinical Social Worker 1041C0700X C009888 NC Primary

Addresses

Primary practice location

10580 Ligon Mill Rd
Suite 210
Wake Forest, NC 27587-6090

Mailing address

10580 Ligon Mill Rd
Suite 210
Wake Forest, NC 27587-6090
Phone (919) 263-9592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20260320002741 WA Practitioner - Clinical Social Worker 9234411760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4321 Major Loring Way
Raleigh, NC 27616-0723

PO Box
Suite 5299
Tacoma, WA 98415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW4885FLMDSocial Worker
C009888NCMDClinical Social Worker

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1710141841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10580 LIGON MILL RD",
            "address_2": "SUITE 210",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876090",
            "telephone_number": "919-263-9592",
            "fax_number": "919-263-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 LIGON MILL RD",
            "address_2": "SUITE 210",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876090",
            "telephone_number": "919-263-9592",
            "fax_number": "919-263-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSKOPF",
        "first_name": "NIOME",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "ISW4885",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.