Active NPI
Jennifer Peeks
- Clinical Social Worker
- Bethel, AK
National Provider Identifier
1528625381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW989
- Practice address
- 631 4TH Ave. & Main St.
Bethel, AK 99559 - Phone
- (907) 543-3773
- NPI assigned
- May 28, 2019
- Last updated
- May 28, 2019
- Sex
- Female
- Sole proprietor
- No
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 | CSW989 | AK | Primary |
Addresses
Primary practice location
631 4TH Ave. & Main St.
Bethel, AK 99559
Mailing address
PO Box 2851
Bethel, AK 99559-2851
Phone (907) 545-5995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW989 | AK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethel Family Clinic | Past | Accepting new patients | |
| Bethel Family Clinic | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Bethel, AK
- NPI 1124078019
-
- Federally Qualified Health Center (FQHC)
- Bethel, AK
- NPI 1891279097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1528625381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2851",
"city": "BETHEL",
"state": "AK",
"postal_code": "995592851",
"telephone_number": "907-545-5995",
"fax_number": "907-545-5995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 4TH AVE. & MAIN ST.",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEEKS",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AK",
"license": "CSW989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.