Individual provider Active NPI

Anna L McLaughlin

  • Clinical Social Worker
  • Shallotte, NC
National Provider Identifier
1770050627
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P012880 Issued in NC
Practice address
3640 Express Dr
Shallotte, NC 28470-6501
Phone
(910) 755-5222
NPI assigned
Oct 30, 2018
Last updated
Oct 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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 P012880 NC Primary

Addresses

Primary practice location

3640 Express Dr
Shallotte, NC 28470-6501

Mailing address

3640 Express Dr
Shallotte, NC 28470-6501
Phone (910) 755-5222

Other identifiers 1

IdentifierTypeStateIssuer
P012880OtherNCNC SOCIAL WORKER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250204000088 SC Practitioner - Clinical Social Worker 0941730162 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P012880NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regenesis Organization Community Health Center Current Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Coastal Southeastern United Care LLC Past Accepting new patients

Locations

301 Crescent Ave
Spartanburg, SC 29306
Phone (864) 582-2817

460 Langdon St
Spartanburg, SC 29302
Phone (864) 582-2817

750 S Church St
Spartanburg, SC 29306
Phone (864) 582-2829

115 Thomas St
#B
Union, SC 29379

Organizations & group practices 8

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": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1770050627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 EXPRESS DR",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284706501",
            "telephone_number": "910-755-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 EXPRESS DR",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284706501",
            "telephone_number": "910-755-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "ANNA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P012880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC SOCIAL WORKER",
            "identifier": "P012880",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.