Active NPI
Kerry Goldman
- Clinical Social Worker
- West End, NC
National Provider Identifier
1962959528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P010874
- Practice address
- 980 7 Lakes Drive
West End, NC 27376 - Phone
- (910) 673-5437
- Fax
- (910) 673-5438
- NPI assigned
- Sep 1, 2016
- Last updated
- Sep 1, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P010874 | NC | Primary |
Addresses
Primary practice location
980 7 Lakes Drive
West End, NC 27376
Mailing address
PO Box 354
West End, NC 27376-0354
Phone (910) 673-5437
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P010874 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moore Pediatric Therapy Serivces | Past | Accepting new patients | |
| Moore Pediatric Therapy Serivces | Clinical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- West End, NC
- NPI 1356701528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1962959528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 354",
"city": "WEST END",
"state": "NC",
"postal_code": "273760354",
"telephone_number": "910-673-5437",
"fax_number": "910-673-5438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 7 LAKES DRIVE",
"city": "WEST END",
"state": "NC",
"postal_code": "27376",
"telephone_number": "910-673-5437",
"fax_number": "910-673-5438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "KERRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P010874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West End, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.