Individual provider Active NPI

Penny J Moers, LCSW

  • Clinical Social Worker
  • Shelbyville, KY
National Provider Identifier
1033389770
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3920 Issued in KY
Practice address
250 Alpine Dr
Shelbyville, KY 40065-8880
Phone
(502) 633-5683
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3920 KY Primary

Addresses

Primary practice location

250 Alpine Dr
Shelbyville, KY 40065-8880

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone (502) 589-8600

Other identifiers 1

IdentifierTypeStateIssuer
30615058MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20150413000770 KY Practitioner - Clinical Social Worker 8628396173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seven Counties Services, IncGroup PAC ID 1759294424, 92 clinicians

Practice addresses (Care Compare)

2141 Spencer CT
La Grange, KY 40031-6742
Phone (502) 222-7201

250 Alpine Dr
Shelbyville, KY 40065-8880
Phone (502) 633-5683

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 589-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3920KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. Clinical CurrentSince Mar 9, 2015 Accepting new patients

Locations

101 W Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 589-8615

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

250 Alpine Dr
Shelbyville, KY 40065
Phone (502) 588-9860

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1033389770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ALPINE DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658880",
            "telephone_number": "502-633-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOERS",
        "first_name": "PENNY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

Verify at the official NPI Registry.