Individual provider Active NPI

John Burns, LCSW

  • Clinical Social Worker
  • Matthews, NC
National Provider Identifier
1881900447
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006707 Issued in NC
Practice address
3503 Weddington Ridge LN
Matthews, NC 28105-7705
Phone
(704) 622-3450
NPI assigned
Aug 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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 C006707 NC Primary

Addresses

Primary practice location

3503 Weddington Ridge LN
Matthews, NC 28105-7705

Mailing address

3503 Weddington Ridge LN
Matthews, NC 28105-7705
Phone (704) 622-3450

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
I20190313001972 NC Practitioner - Clinical Social Worker 0143560920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4108 Park Rd
Suite 408
Charlotte, NC 28209-2262
Phone (980) 907-2466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina Clinical CurrentSince Feb 1, 2019 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Feb 1, 2019 Accepting new patients
Montgomery Group, LLC Clinical CurrentSince Dec 6, 2018 Accepting new patients

Locations

4108 Park Rd
Ste 408
Charlotte, NC 28209
Phone (980) 907-2466

4108 Park Rd
Ste 410
Charlotte, NC 28209
Phone (704) 629-8737

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

Organizations & group practices 3

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1881900447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 WEDDINGTON RIDGE LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281057705",
            "telephone_number": "704-622-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 WEDDINGTON RIDGE LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281057705",
            "telephone_number": "704-622-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "JOHN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.