Active NPI
Coreen Payne
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1750960357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW136279
- Practice address
- 1740 South St
Philadelphia, PA 19146-1514 - Phone
- (440) 823-7378
- NPI assigned
- Apr 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW136279 | PA | Primary |
Addresses
Primary practice location
1740 South St
Philadelphia, PA 19146-1514
Mailing address
285 W Haines St
Philadelphia, PA 19144-3318
Phone (440) 823-7378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW136279 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177
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": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1750960357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 W HAINES ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191443318",
"telephone_number": "440-823-7378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 SOUTH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191461514",
"telephone_number": "440-823-7378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "COREEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "SW136279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.