Individual provider Active NPI

Rhonda Payne, ACSW, LCSW

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1811057177
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
817 Issued in TN
Practice address
780 Ridge Lake Blvd
Suite 103
Memphis, TN 38120-9426
Phone
(901) 767-0990
Fax
(901) 755-2040
NPI assigned
Dec 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 817 TN Primary

Addresses

Primary practice location

780 Ridge Lake Blvd
Suite 103
Memphis, TN 38120-9426

Mailing address

PO Box 3914
Cordova, TN 38088-3914
Phone (901) 767-0990

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
I20050203000612 TN Practitioner - Clinical Social Worker 2163473463 Practice locations: Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

780 Ridge Lake Blvd
Suite 103
Memphis, TN 38120-9426
Phone (901) 767-0990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811057177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3914",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380883914",
            "telephone_number": "901-767-0990",
            "fax_number": "901-755-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 RIDGE LAKE BLVD",
            "address_2": "SUITE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209426",
            "telephone_number": "901-767-0990",
            "fax_number": "901-755-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "RHONDA",
        "name_prefix": "Ms.",
        "credential": "ACSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.