Individual provider Active NPI

Jeanne B Racer, LCSW

  • Clinical Social Worker
  • Bonners Ferry, ID
National Provider Identifier
1245986264
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-41739 Issued in ID
Practice address
147 Emerson LN
Bonners Ferry, ID 83805-6153
Phone
(208) 267-7522
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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 LCSW-41739 ID Primary

Addresses

Primary practice location

147 Emerson LN
Bonners Ferry, ID 83805-6153

Mailing address

594 Lost Mile Rd
Bonners Ferry, ID 83805-4904
Phone (208) 217-2162

Other practice location 1

594 Lost Mile Rd
Bonners Ferry, ID 83805-4904
Phone (208) 217-2162

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220624000913 ID Practitioner - Clinical Social Worker 7810376670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boundary Community HospitalGroup PAC ID 3274583406, 29 clinicians

Practice addresses (Care Compare)

4750 N Five Mile Rd
Boise, ID 83713-2715
Phone (208) 996-0931

6640 Kaniksu St
Bonners Ferry, ID 83805-7532
Phone (208) 267-3141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-41739IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boundary Community Hospital CurrentSince Sep 1, 2024 Accepting new patients
Valley Behavioral Health Incorporated Clinical CurrentSince Oct 19, 2022 Accepting new patients
Boundary Community Hospital CurrentSince Sep 1, 2024 Accepting new patients

Locations

4750 N Five Mile Rd
Boise, ID 83713
Phone (208) 375-0500

6641 Kaniksu St
Bonners Ferry, ID 83805
Phone (208) 267-3141

6640 Kaniksu St
Bonners Ferry, ID 83805
Phone (208) 267-3141

Interoperability endpoints

  • Direct secure messaging: jeanne.racer.p90@direct.kootenai.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1245986264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "594 LOST MILE RD",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838054904",
            "telephone_number": "208-217-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 EMERSON LN",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838056153",
            "telephone_number": "208-267-7522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "594 Lost Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Bonners Ferry",
            "state": "ID",
            "postal_code": "838054904",
            "country_code": "US",
            "telephone_number": "208-217-2162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RACER",
        "first_name": "JEANNE",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-41739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonners Ferry, ID

Sources for this page

Verify at the official NPI Registry.