Individual provider Active NPI

Ana Rita Blaney, LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1902049844
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008610 Issued in NC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 343-0145
Fax
(910) 341-5779
NPI assigned
Apr 8, 2009
Reactivated
Mar 14, 2016
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 C008610 NC Primary

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

3002 Lauren Place Dr Apt 103
Wilmington, NC 28405-2114
Phone (910) 352-7034

Other practice location 1

6209 Oleander Dr
Suite 215
Wilmington, NC 28403-3581
Phone (910) 352-7034

Other practice location 2

6209 Oleander Dr
Suite 215
Wilmington, NC 28403-3581
Phone (910) 352-7034

Other identifiers 1

IdentifierTypeStateIssuer
1902049844MedicaidNC

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
I20160512000017 NC Practitioner - Clinical Social Worker 9032408299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Horizons Center, Inc.Group PAC ID 9739267964, 50 clinicians

Practice addresses (Care Compare)

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C008610NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Horizons Center, Inc CurrentSince Mar 28, 2016 Accepting new patients
Coastal Horizons Center Inc CurrentSince Mar 28, 2016 Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients

Locations

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902049844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 LAUREN PLACE DR APT 103",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052114",
            "telephone_number": "910-352-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6209 Oleander Dr",
            "address_2": "Suite 215",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284033581",
            "country_code": "US",
            "telephone_number": "910-352-7034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6209 Oleander Dr",
            "address_2": "Suite 215",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284033581",
            "country_code": "US",
            "telephone_number": "910-352-7034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANEY",
        "first_name": "ANA",
        "middle_name": "RITA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2018-03-17",
        "deactivation_date": "2011-08-22",
        "reactivation_date": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902049844",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.