Active NPI
Judith Anne Peelle, LMSW
- Clinical Social Worker
- Allegan, MI
National Provider Identifier
1487653465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801068379
- Practice address
- 3855 Forest TRL
Allegan, MI 49010-9465 - Phone
- (269) 355-6089
- NPI assigned
- Jul 20, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801068379 | MI | Primary |
Addresses
Primary practice location
3855 Forest TRL
Allegan, MI 49010-9465
Mailing address
3855 Forest TRL
Allegan, MI 49010-9465
Phone (269) 355-6089
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068379 | Other | MI | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
801 Hazen St
Suite C
Paw Paw, MI 49079-2008
Phone (269) 657-5574
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Psychiatry Physician
- Paw Paw, MI
- NPI 1003878554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221609600000",
"number": "1487653465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3855 FOREST TRL",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490109465",
"telephone_number": "269-355-6089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3855 FOREST TRL",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490109465",
"telephone_number": "269-355-6089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEELLE",
"first_name": "JUDITH",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-20",
"last_updated": "2008-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801068379",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "068379",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.