Individual provider Active NPI

Keturah Rose Ross, LCSWA

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1851060610
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C018175 Issued in NC
Practice address
919 Wild Wolf Dr
Greensboro, NC 27406-8282
Phone
(336) 926-8339
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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 C018175 NC Primary

Addresses

Primary practice location

919 Wild Wolf Dr
Greensboro, NC 27406-8282

Mailing address

919 Wild Wolf Dr
Greensboro, NC 27406-8282
Phone (336) 926-8339

Other practice location 1

8007 N Point Blvd Ste A
Winston Salem, NC 27106-3268
Phone (866) 700-1606

Other practice location 2

1001 Reynolda Rd
Winston Salem, NC 27104-3245
Phone (336) 721-7600

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
I20260508001768 NC Practitioner - Clinical Social Worker 7911475884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3545 Whitehall Park Dr
Suite 300
Charlotte, NC 28273-4179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C018175NCMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1851060610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 WILD WOLF DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274068282",
            "telephone_number": "336-926-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 WILD WOLF DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274068282",
            "telephone_number": "336-926-8339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8007 N Point Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063268",
            "country_code": "US",
            "telephone_number": "866-700-1606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Reynolda Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271043245",
            "country_code": "US",
            "telephone_number": "336-721-7600",
            "fax_number": "336-728-4355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KETURAH",
        "middle_name": "ROSE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C018175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.