Active NPI
Keri Smith Gaylord, LCSW
- Clinical Social Worker
- Yadkinville, NC
National Provider Identifier
1831590165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C009817
- Practice address
- 624 W Main St
Yadkinville, NC 27055-7804 - Phone
- (336) 849-7890
- Fax
- (336) 849-7891
- NPI assigned
- Sep 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C009817 | NC | Primary |
Addresses
Primary practice location
624 W Main St
Yadkinville, NC 27055-7804
Mailing address
2000 Walnut Crossing Run
Yadkinville, NC 27055-8081
Phone (904) 887-5911
Other practice location 1
6614 Shallowford Rd Ste 200
Lewisville, NC 27023-9304
Phone (336) 849-7890
Other practice location 2
617 S Green St
Suite 300
Morganton, NC 28655-3517
Phone (828) 437-3000
Other practice location 3
2554 Lewisville Clemmons Rd Ste 303
Clemmons, NC 27012-8749
Phone (336) 849-7890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| #P009058 | Other | NC | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C009817 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1831590165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 WALNUT CROSSING RUN",
"city": "YADKINVILLE",
"state": "NC",
"postal_code": "270558081",
"telephone_number": "904-887-5911",
"fax_number": "336-849-7891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 W MAIN ST",
"city": "YADKINVILLE",
"state": "NC",
"postal_code": "270557804",
"telephone_number": "336-849-7890",
"fax_number": "336-849-7891"
}
],
"practiceLocations": [
{
"address_1": "6614 Shallowford Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Lewisville",
"state": "NC",
"postal_code": "270239304",
"country_code": "US",
"telephone_number": "336-849-7890",
"fax_number": "336-849-7891",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "617 S Green St",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Morganton",
"state": "NC",
"postal_code": "286553517",
"country_code": "US",
"telephone_number": "828-437-3000",
"fax_number": "828-437-4999",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2554 Lewisville Clemmons Rd Ste 303",
"address_purpose": "LOCATION",
"city": "Clemmons",
"state": "NC",
"postal_code": "270128749",
"country_code": "US",
"telephone_number": "336-849-7890",
"fax_number": "336-849-7891",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAYLORD",
"first_name": "KERI",
"middle_name": "SMITH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-05",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C009817",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "#P009058",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yadkinville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.