Individual provider Active NPI

Jeanneelizabeth Palanza, LCSWA

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1720475064
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P008262 Issued in NC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 343-0145
Fax
(910) 341-5779
NPI assigned
Apr 24, 2015
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 P008262 NC Primary

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

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
I20170926000515 NC Practitioner - Clinical Social Worker 7810261187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pace Health Network LLCGroup PAC ID 2567742513, 8 clinicians

Practice addresses (Care Compare)

206 Wannish Ave
Lake Waccamaw, NC 28450-2216
Phone (910) 646-3154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P008262NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Health Network, LLC CurrentSince Aug 15, 2017 Accepting new patients

Locations

206 Wannish Ave
Lake Waccamaw, NC 28450
Phone (910) 646-3153

209 W Virgil St
Whiteville, NC 28472
Phone (910) 640-2430

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1720475064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALANZA",
        "first_name": "JEANNEELIZABETH",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.