Individual provider Active NPI

Eddie Straw Wright Jr., SOCIAL WORKER

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1821369299
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007593 Issued in NC
Practice address
401 Edwinstowe Ave
Fayetteville, NC 28311-1162
Phone
(910) 286-0125
NPI assigned
Jan 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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 C007593 NC Primary

Addresses

Primary practice location

401 Edwinstowe Ave
Fayetteville, NC 28311-1162

Mailing address

401 Edwinstowe Ave
Fayetteville, NC 28311-1162
Phone (910) 286-0125

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
C007593NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1821369299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 EDWINSTOWE AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111162",
            "telephone_number": "910-286-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EDWINSTOWE AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111162",
            "telephone_number": "910-286-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "EDDIE",
        "middle_name": "STRAW",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.