Individual provider Active NPI

Julie Moore, LCSW

  • Clinical Social Worker
  • Gallatin, TN
National Provider Identifier
1720516131
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6479 Issued in TN
Practice address
150 W Main St # 330
Gallatin, TN 37066-3251
Phone
(615) 451-0250
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2017

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 6479 TN Primary

Addresses

Primary practice location

150 W Main St # 330
Gallatin, TN 37066-3251

Mailing address

121 Brooks LN
Portland, TN 37148-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20171206000070 TN Practitioner - Clinical Social Worker 5193082899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1404 E Broadway
Suite 3
Gallatin, TN 37066-4613
Phone (614) 451-0250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rachel B. Dorris, LCSW, LLC Clinical CurrentSince Sep 6, 2017 Accepting new patients

Locations

1404 E Broadway
Ste 3
Gallatin, TN 37066
Phone (614) 451-0250

150 W Main St
Ste 303
Gallatin, TN 37066
Phone (614) 451-0250

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1720516131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BROOKS LN",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371484949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W MAIN ST # 330",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663251",
            "telephone_number": "615-451-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JULIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.