Individual provider Active NPI

Kathryn Peek

  • Social Worker
  • Wichita, KS
National Provider Identifier
1548619125
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
9964 Issued in KS
Practice address
939 N Main St
Wichita, KS 67203-3608
Phone
(316) 263-8807
Fax
(316) 263-9681
NPI assigned
Jun 6, 2016
Last updated
Jun 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 9964 KS Primary

Addresses

Primary practice location

939 N Main St
Wichita, KS 67203-3608

Mailing address

939 N Main St
Wichita, KS 67203-3608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20200310001512 KS Practitioner - Clinical Social Worker 5193153930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Haus of Clarity LLCGroup PAC ID 4880983352, 6 clinicians

Practice addresses (Care Compare)

1635 N Waterfront Pkwy
Suite 135
Wichita, KS 67206-6624
Phone (316) 927-3010

8080 E Central Ave
Suite 320
Wichita, KS 67206-2389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9964KSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Treatment Center, Inc PastSince Aug 18, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1548619125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033608",
            "telephone_number": "316-263-8807",
            "fax_number": "316-263-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEK",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.