Russell A. Weathersby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4865 Issued in OR

Practice address

154 Medical Park Loop
Sylva, NC 28779-5222

Phone

(828) 631-3973

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/clatsopbh/r4/

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.

• Clatsop Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Warrenton, OR
  • NPI 1013925155
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1962425975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 574",
            "city": "ZEPHYR COVE",
            "state": "NV",
            "postal_code": "894480574",
            "telephone_number": "828-713-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 MEDICAL PARK LOOP",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795222",
            "telephone_number": "828-631-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERSBY",
        "first_name": "RUSSELL",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4865",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5103-C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003455",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "135RN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elise Waterbury
• Erik Michael Watkins, PT
• Heidi Watkins
• Sarah Brown Watkins, FNP
• Amy Watson
• Daniel Riley Webb
• Webster Enterprises of Jackson County, Inc.
• Wellspring Family Practice, PA
• Westcare (HRH Transitional Care Unit)
• Western Carolina Counseling Services PA

• Clinical Social Worker in Sylva, NC
• Providers in Sylva, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.