Charlotte Bond Bailey, LCSW
Individual provider Active NPI Clinical Social Worker · McMinnville, TN
NPI 1972519296 · NPPES record last updated May 2, 2022
Key facts
- NPI
- 1972519296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4546 (TN)
- Practice address
- 207 Oak Park
McMinnville, TN 37110-1336 - Phone
- (931) 474-4000
- Fax
- (931) 474-4001
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Care Wellness LLC
Practice addresses (Care Compare)
207 Oak Park
McMinnville, TN 37110-1336
Phone (931) 474-4000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060830000473 | TN | Practitioner - Clinical Social Worker | 4789688987 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4546 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Wellness LLC | Single Specialty | Current |
Accepting new patients |
| Blankenship Medical Group PLLC | Single Specialty | Past |
Accepting new patients |
Locations
207 Oak Park
McMinnville, TN 37110
Phone (931) 474-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 4546 | TN | Yes |
Addresses
Primary practice location
207 Oak Park
McMinnville, TN 37110-1336
Mailing address
207 Oak Park
McMinnville, TN 37110-1336
Phone (615) 477-7215
Other practice location 1
306 N Chancery St
McMinnville, TN 37110-2048
Phone (931) 474-4700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103I806220 | Medicaid | TN |
Other providers in McMinnville, TN
- Sonya Melissa Armstrong
- Atlas Emergency Physicians, PLLC
- Stephanie Audas
- B P Ortho PC
- Back to Health
- Carrie Elaine Baines
- Jeanne Kay Ball
- Elizabeth Haley Ballard
- Kaylyn Mackenzie Banks
- Barren Forks Inpatient Services PLLC
All providers in McMinnville, TN · Clinical Social Worker in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.