Individual provider Active NPI

Alexandra Blanco

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1932873866
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P016673 Issued in NC
Practice address
3012 Falstaff Rd
Raleigh, NC 27610-1813
Phone
(919) 615-1027
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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 P016673 NC Primary

Addresses

Primary practice location

3012 Falstaff Rd
Raleigh, NC 27610-1813

Mailing address

4122 Chinese Fir TRL
Raleigh, NC 27610-6656
Phone (910) 627-7368

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
I20240514002962 NC Practitioner - Clinical Social Worker 5193166700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Outreach, LLCGroup PAC ID 0446449748, 17 clinicians

Practice addresses (Care Compare)

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone (919) 251-9001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P016673NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Outreach, LLC Clinical CurrentSince Mar 31, 2024 Accepting new patients
Carolina Outreach, LLC Clinical CurrentSince Mar 31, 2024 Accepting new patients

Locations

2670 Durham Chapel Hill Blvd
Durham, NC 27707
Phone (919) 251-9009

3012 Falstaff Rd
Raleigh, NC 27610
Phone (919) 424-6647

Organizations & group practices 2

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": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1932873866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 CHINESE FIR TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276106656",
            "telephone_number": "910-627-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 FALSTAFF RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101813",
            "telephone_number": "919-615-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.