Corene Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-34038 Issued in ID

Practice address

1565 E Lincoln Rd
Idaho Falls, ID 83401-2129

Phone

(208) 524-8996

Fax

(208) 524-1205

NPI assigned

Feb 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Joshua D. Smith and Associates, Inc.Group PAC ID 9739326547, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Joshua D Smith and Associates Inc

  • Community/Behavioral Health Agency
  • Idaho Falls, ID
  • NPI 1144351461

  Clinical

  Medicare reassignment Care Compare group NPD
• Joshua D Smith and Associates Inc

  • Community/Behavioral Health Agency
  • Idaho Falls, ID
  • NPI 1174654768

  Clinical

  NPD

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1003188897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 E LINCOLN RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012129",
            "telephone_number": "208-524-8996",
            "fax_number": "208-524-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 E LINCOLN RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012129",
            "telephone_number": "208-524-8996",
            "fax_number": "208-524-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CORENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-34038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Petersen
• Peterson Speech Therapy
• Peterson Therapy Services, Inc
• Chase Peterson, DPT
• Chelsea Joan Peterson, MOTR/L
• Malik Peterson, DO, DO
• Emily Peterson
• Jason M Peterson, DDS
• Jennifer Rae Peterson, LMSW
• Leon C Peterson, O.D.

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.