Active NPI
Katie Dockery Moser, LCSW
- Clinical Social Worker
- Yadkinville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C011600
- Practice address
- 320 E Lee Ave
Yadkinville, NC 27055-8132 - Phone
- (336) 589-8059
- NPI assigned
- Jun 29, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P010618 | NC | |
| Clinical Social Worker | 1041C0700X | C011600 | NC | Primary |
Addresses
Primary practice location
320 E Lee Ave
Yadkinville, NC 27055-8132
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100
Other names 1
- Katie Lynn Dockery
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
320 E Lee Ave
Yadkinville, NC 27055-8132
Phone (336) 679-8805
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P010618 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daymark Recovery Services, Inc. | Clinical | Current | Accepting new patients |
Locations
284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118
1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836
2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616
227 N Main St
Troy, NC 27371
Phone (910) 572-3681
320 E Lee Ave
Yadkinville, NC 27055
Phone (336) 679-8805
Interoperability endpoints
- katie.dockerymoser.p1@direct.daymarkrecovery.nextgenshare.com
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": "1467158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1760833842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E LEE AVE",
"city": "YADKINVILLE",
"state": "NC",
"postal_code": "270558132",
"telephone_number": "336-589-8059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSER",
"first_name": "KATIE",
"middle_name": "DOCKERY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-29",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P010618",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C011600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATIE",
"last_name": "DOCKERY",
"middle_name": "LYNN",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Yadkinville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.