Active NPI
Antoinette Fobbs, LCSW-C
- Clinical Social Worker
- Clayton, NC
National Provider Identifier
1912567355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 23522
- Practice address
- 216 Elway Dr
Clayton, NC 27527-6566 - Phone
- (301) 221-2370
- NPI assigned
- Jun 18, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MD | ||
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 23522 | MD | Primary |
Addresses
Primary practice location
216 Elway Dr
Clayton, NC 27527-6566
Mailing address
216 Elway Dr
Clayton, NC 27527-6566
Phone (301) 221-2370
Other names 1
- Antoinette Fobbs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23522 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Medical, P.C. | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- San Francisco, CA
- NPI 1801355482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697241600000",
"number": "1912567355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 ELWAY DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275276566",
"telephone_number": "301-221-2370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 ELWAY DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275276566",
"telephone_number": "301-221-2370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOBBS",
"first_name": "ANTOINETTE",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2023-10-14",
"certification_date": "2023-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "23522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANTOINETTE",
"last_name": "FOBBS",
"credential": "LCSW-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.