Individual provider Active NPI

Rachel D Pakenham, MSW

  • Clinical Social Worker
  • Frederiksted, VI
National Provider Identifier
1255483095
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2-2050103-2008 Issued in VI
Practice address
79 A la Grange
Fleming Circle
Frederiksted, VI 00841-0661
Phone
(340) 772-3327
NPI assigned
Jan 18, 2007
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 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 C002517 NC
Clinical Social Worker 1041C0700X 2-2050103-2008 VI Primary

Addresses

Primary practice location

79 A la Grange
Fleming Circle
Frederiksted, VI 00841-0661

Mailing address

PO Box 661
Frederiksted, VI 00841-0661
Phone (340) 772-5209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20201009000473 VI Practitioner - Clinical Social Worker 3476973629 Practice locations: Frederiksted, VI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 A Strand St
Frederiksted, VI 00840
Phone (340) 725-3440

419 Fleming Cir
Frederiksted, VI 00840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C002517NCMDClinical Social Worker
2-2050103-2008VIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rachel's Place Clinical CurrentSince May 3, 2020 Accepting new patients

Locations

419 Fleming Cir
Frederiksted, VI 00840

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1255483095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661",
            "city": "FREDERIKSTED",
            "state": "VI",
            "postal_code": "008410661",
            "telephone_number": "340-772-5209",
            "fax_number": "340-713-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 A LA GRANGE",
            "address_2": "FLEMING CIRCLE",
            "city": "FREDERIKSTED",
            "state": "VI",
            "postal_code": "008410661",
            "telephone_number": "340-772-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKENHAM",
        "first_name": "RACHEL",
        "middle_name": "D",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002517",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VI",
            "license": "2-2050103-2008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederiksted, VI

Sources for this page

Verify at the official NPI Registry.