Individual provider Active NPI

Kirt Eric Carter

  • Clinical Social Worker
  • Ironwood, MI
National Provider Identifier
1821320623
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801046812 Issued in MI
Practice address
629 W Cloverland Dr
Suite 1
Ironwood, MI 49938-1006
Phone
(906) 932-0032
NPI assigned
Feb 3, 2010
Last updated
Feb 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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 6801046812 MI Primary

Addresses

Primary practice location

629 W Cloverland Dr
Suite 1
Ironwood, MI 49938-1006

Mailing address

605 Bedell Ave
Wakefield, MI 49968-1511
Phone (574) 612-2106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801046812MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1821320623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 BEDELL AVE",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499681511",
            "telephone_number": "574-612-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W CLOVERLAND DR",
            "address_2": "SUITE 1",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499381006",
            "telephone_number": "906-932-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KIRT",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801046812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ironwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.