Individual provider Active NPI

Kerri Ann Boykin, LCSWA

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1952824179
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P011808 Issued in NC
Practice address
920 Cambridge St
Fayetteville, NC 28303-5300
Phone
(910) 493-3555
Fax
(910) 493-3520
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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 P011808 NC Primary

Addresses

Primary practice location

920 Cambridge St
Fayetteville, NC 28303-5300

Mailing address

6633 Hillbrook Rd
Hope Mills, NC 28348-9715
Phone (991) 062-4227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P011808NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1952824179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6633 HILLBROOK RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283489715",
            "telephone_number": "991-062-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CAMBRIDGE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035300",
            "telephone_number": "910-493-3555",
            "fax_number": "910-493-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYKIN",
        "first_name": "KERRI ANN",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.