NPIMap

Organization Active NPI

County of Iredell

  • Social Worker
  • Statesville, NC
National Provider Identifier
1811221278
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
COUNTY OF IREDELL
Practice address
549 Eastside Dr
Statesville, NC 28625-6317
Phone
(704) 873-5631
Fax
(704) 871-3489
NPI assigned
Oct 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Cynthia Y Smith
Title
DSS Director
Phone
(704) 878-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

549 Eastside Dr
Statesville, NC 28625-6317

Mailing address

549 Eastside Dr
Statesville, NC 28625-6317
Phone (704) 873-5631

Other identifiers 1

IdentifierTypeStateIssuer
3408475MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Iredell County Health D9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

549 Eastside Dr
Statesville, NC 28625
Phone (704) 873-5631

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1811221278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 EASTSIDE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286256317",
            "telephone_number": "704-873-5631",
            "fax_number": "704-871-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 EASTSIDE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286256317",
            "telephone_number": "704-873-5631",
            "fax_number": "704-871-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF IREDELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "DSS DIRECTOR",
        "authorized_official_telephone_number": "704-878-5000"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408475",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.