Mr Kenneth Louis Shore, LCSW in Raleigh, NC - Medicare Social Worker Provider

Mr Kenneth Louis Shore, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Raleigh, North Carolina. His current practice location is 4112 Blue Ridge Road, 2nd Floor, Raleigh, North Carolina. You can reach out to his office (for appointments etc.) via phone at (919) 573-6520.

Mr Kenneth Louis Shore is licensed to practice in North Carolina (license number C003006) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1871762641.

Contact Information

	Mr Kenneth Louis Shore, LCSW
	4112 Blue Ridge Road, 2nd Floor, Raleigh, NC 27612-4652
	(919) 573-6520
	(919) 573-6557

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Kenneth Louis Shore
Gender	Male
Speciality	Social Worker - Clinical
Location	4112 Blue Ridge Road, Raleigh, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871762641
Provider Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008

Medicare PECOS Information:

PECOS PAC ID: 3971644634
Enrollment ID: I20100104000443

Medical Identifiers

Medical identifiers for Mr Kenneth Louis Shore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871762641	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	C003006 (North Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Kenneth Louis Shore allows following entities to bill medicare on his behalf.

Entity Name	Mindpath Care Centers North Carolina Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508803214 PECOS PAC ID: 4688655517 Enrollment ID: O20040526001582

Entity Name	Family Service Of The Piedmont, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881773554 PECOS PAC ID: 8426182965 Enrollment ID: O20100818001335

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kenneth Louis Shore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Kenneth Louis Shore, LCSW 25 Blackstone Valley Place, Suite 300 Fellowship Health Resources Inc, Lincoln, RI 02865-1163 Ph: (401) 333-3980	Mr Kenneth Louis Shore, LCSW 4112 Blue Ridge Road, 2nd Floor, Raleigh, NC 27612-4652 Ph: (919) 573-6520

Reviews and Comments

Social Worker in Raleigh, NC

Ms. Tonya R Gable, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3000 New Bern Ave, Raleigh, NC 27610 Phone: 919-350-4163 Fax: 919-350-8509
Ms. Holly H Head, P-LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3000 New Bern Ave, Raleigh, NC 27610 Phone: 919-350-7445 Fax: 919-350-8509
Carol D Kassey, MSW. LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5850 Faringdon Pl, Raleigh, NC 27609 Phone: 919-872-9974 Fax: 919-872-9975
Miss Kimberly G. Kueny, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1001 Navaho Dr, Suite 210, Raleigh, NC 27609 Phone: 919-872-1178 Fax: 919-872-1170
Casey Paganucci, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8105 Fayetteville Rd, Suite 121-2038, Raleigh, NC 27603 Phone: 919-364-5386
Amy Lynn Bryan, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4000 Wake Forest Rd, Suite 200, Raleigh, NC 27609 Phone: 919-865-8710
Miss Darnesha Coleman, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3125 Poplarwood Ct Ste 300, Raleigh, NC 27604 Phone: 919-790-8580

Mr Kenneth Louis Shore, LCSW - Medicare Clinical Social Worker in Raleigh, NC