De'Mone' Camil Jordan, LCSW, LCAS-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C014449 Issued in NC

Practice address

1381 Medical Center Dr
Roanoke Rapids, NC 27870-5130

Phone

(252) 519-2955

Fax

(252) 519-0655

NPI assigned

Mar 30, 2020

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rural Health Group IncGroup PAC ID 9739090226, shared by 19 NPIs, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rural Health Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roanoke Rapids, NC
  • NPI 1598253734
  Medicare reassignment NPD
• Rural Health Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roanoke Rapids, NC
  • NPI 1871081000
  Medicare reassignment NPD
• Rural Health Group, Inc.

  dba Rural Health Group at Jackson

  • Federally Qualified Health Center (FQHC)
  • Jackson, NC
  • NPI 1689626178
  NPD

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1780212308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278700640",
            "telephone_number": "252-536-5440",
            "fax_number": "252-536-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 MEDICAL CENTER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278705130",
            "telephone_number": "252-519-2955",
            "fax_number": "252-519-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DE'MONE'",
        "middle_name": "CAMIL",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joey P. Thomas, M.D.
• Paulette Renee Johnson-Hedgepeth, LCSWA
• Cathy Jo Jones, CFTS
• Cheryl Anita Jones
• Haile Jones, MD
• K. Jasinski, D.M.D., P.C. (Roanoke Rapids Dental Care)
• Kamlesh Gupta MD (Halifax Pathology)
• Elysee Ama Bonsu Karikari-Agyeman
• Kathryn Bennett
• Morgan Keeter, NP-C

• Clinical Social Worker in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.
• 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.

Verify at the official NPI Registry.