Individual provider Active NPI

John Folsom Noteware III, LCSW, LMSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1922305069
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW20128 Issued in FL
Practice address
6817 Southpoint Pkwy
Jacksonville, FL 32216-6282
Phone
(904) 399-0324
NPI assigned
Feb 25, 2011
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094310 MI
Clinical Social Worker 1041C0700X SW20128 FL Primary

Addresses

Primary practice location

6817 Southpoint Pkwy
Jacksonville, FL 32216-6282

Mailing address

3818 Union Pacific Dr W
Jacksonville, FL 32246-6607
Phone (904) 884-3005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230606002045 FL Practitioner - Clinical Social Worker 0345557765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1090 S Tamiami TRL
Sarasota, FL 34236-9116
Phone (941) 363-0878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW20128FLMDClinical Social Worker
6801094310MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, P.C. Clinical CurrentSince Feb 15, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, PC CurrentSince Feb 15, 2024 Accepting new patients
National Council on Alcoholism Drug Dependence Past Accepting new patients
National Council on Alcoholism & Drug Dependence Greater Detroit Addiction (Substance Use Disorder) Past Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 2402
Jacksonville, FL 32216
Phone (850) 893-8800

1090 Tamiami Trl
Sarasota, FL 34236
Phone 94136308782005

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": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1922305069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 UNION PACIFIC DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466607",
            "telephone_number": "904-884-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166282",
            "telephone_number": "904-399-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTEWARE",
        "first_name": "JOHN",
        "middle_name": "FOLSOM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-25",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094310",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.