Active NPI
Carol Runyon
- Clinical Social Worker
- North Port, FL
National Provider Identifier
1881358547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW7457
- Practice address
- 2574 Commerce Pkwy
North Port, FL 34289-9334 - Phone
- (941) 485-0121
- Fax
- (941) 485-0519
- NPI assigned
- Oct 28, 2021
- 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 | SW7457 | FL | Primary |
Addresses
Primary practice location
2574 Commerce Pkwy
North Port, FL 34289-9334
Mailing address
PO Box 631278
Cincinnati, OH 45263-1278
Phone (941) 485-0121
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 |
|---|---|---|---|
| SW7457 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1881358547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631278",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452631278",
"telephone_number": "941-485-0121",
"fax_number": "941-485-0519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2574 COMMERCE PKWY",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "342899334",
"telephone_number": "941-485-0121",
"fax_number": "941-485-0519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNYON",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-28",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW7457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Port, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.