Individual provider Active NPI

Aimee E Peterson, CSW-PIP

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1164086450
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5050 Issued in SD
Practice address
1601 E 69TH St Ste 206
Sioux Falls, SD 57108-8322
Phone
(605) 215-4364
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62088 MN
Clinical Social Worker 1041C0700X 5050 SD Primary

Addresses

Primary practice location

1601 E 69TH St Ste 206
Sioux Falls, SD 57108-8322

Mailing address

1601 E 69TH St Ste 206
Sioux Falls, SD 57108-8322
Phone (605) 215-4364

Other identifiers 2

IdentifierTypeStateIssuer
1164086450MedicaidSD
1477179919MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20200420003431 SD Practitioner - Clinical Social Worker 9830529510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1601 E 69TH St
Suite 206
Sioux Falls, SD 57108-8322
Phone (605) 215-4364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62088MNMDAdvanced Heart Failure and Transplant Cardiology Physician
5050SDMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling, LLC Clinical CurrentSince May 1, 2020 Accepting new patients

Locations

1601 E 69th St
Ste 206
Sioux Falls, SD 57108
Phone (605) 215-4364

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1164086450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E 69TH ST STE 206",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088322",
            "telephone_number": "605-215-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 69TH ST STE 206",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088322",
            "telephone_number": "605-215-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "AIMEE",
        "middle_name": "E",
        "credential": "CSW-PIP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "62088",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "5050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164086450",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477179919",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.