Individual provider Active NPI

Elizabeth Gillam Hoffmier, LCSW

  • Clinical Social Worker
  • Nags Head, NC
National Provider Identifier
1720094972
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005107 Issued in NC
Practice address
119 W Wood Hill Dr Ste 5
Nags Head, NC 27959-8700
Phone
(252) 441-7053
Fax
(252) 441-0760
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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 C005107 NC Primary

Addresses

Primary practice location

119 W Wood Hill Dr Ste 5
Nags Head, NC 27959-8700

Mailing address

PO Box 88
Nags Head, NC 27959-0088
Phone (252) 441-7053

Other identifiers 2

IdentifierTypeStateIssuer
141V8OtherNCBCBS ID NUMBER
6106109MedicaidNC

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
I20051021000262 NC Practitioner - Clinical Social Worker 1759307416 Practice locations: Nags Head, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 W Wood Hill Dr
Suite 5
Nags Head, NC 27959-8700
Phone (252) 441-7053

PO Box
Suite 88
Nags Head, NC 27959-0088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pride in North Carolina, LLC Past Accepting new patients

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1720094972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279590088",
            "telephone_number": "252-441-7053",
            "fax_number": "252-441-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W WOOD HILL DR STE 5",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598700",
            "telephone_number": "252-441-7053",
            "fax_number": "252-441-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMIER",
        "first_name": "ELIZABETH",
        "middle_name": "GILLAM",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID NUMBER",
            "identifier": "141V8",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106109",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

Verify at the official NPI Registry.