Individual provider Active NPI

Alexis Tremble

  • Clinical Social Worker
  • Matthews, NC
National Provider Identifier
1821639378
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012238 Issued in NC
Practice address
1450 Matthews Township Pkwy Ste 110
Matthews, NC 28105-2388
Phone
(704) 316-7740
Fax
(704) 316-7745
NPI assigned
Oct 7, 2019
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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 C012238 NC Primary

Addresses

Primary practice location

1450 Matthews Township Pkwy Ste 110
Matthews, NC 28105-2388

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001
Phone (980) 242-2041

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221007001425 NC Practitioner - Clinical Social Worker 8123404555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1450 Matthews Township Pkwy
Suite 110
Matthews, NC 28105-2388
Phone (704) 316-7740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C012238NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 29, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 29, 2022 Accepting new patients
Designed Minds Counseling and Consultation, PLLC Clinical Current Accepting new patients

Locations

10130 Mallard Creek Rd
Ste 300
Charlotte, NC 28262
Phone (704) 754-6137

325 Hawthorne Ln
Ste 100
Charlotte, NC 28204
Phone (704) 316-7763

1450 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 316-7740

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1821639378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MATTHEWS TOWNSHIP PKWY STE 110",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052388",
            "telephone_number": "704-316-7740",
            "fax_number": "704-316-7745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10130 Mallard Creek Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282626001",
            "country_code": "US",
            "telephone_number": "980-242-2041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREMBLE",
        "first_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.