Active NPI
Kishore Boone
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1881120061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P013194
- Practice address
- 3253 Calumet Dr
Apt N
Raleigh, NC 27610-2955 - Phone
- (252) 676-5326
- NPI assigned
- May 7, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Clinical Social Worker | 1041C0700X | P013194 | NC | Primary |
Addresses
Primary practice location
3253 Calumet Dr
Apt N
Raleigh, NC 27610-2955
Mailing address
3253 Calumet Dr
Apt N
Raleigh, NC 27610-2955
Phone (252) 676-5326
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
| License | State | Type | Specialty |
|---|---|---|---|
| P013194 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1881120061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3253 CALUMET DR",
"address_2": "APT N",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276102955",
"telephone_number": "252-676-5326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3253 CALUMET DR",
"address_2": "APT N",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276102955",
"telephone_number": "252-676-5326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOONE",
"first_name": "KISHORE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-07",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P013194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.