Jessica Peacock, CSWA

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

375 NW Beaver St Ste 101
Prineville, OR 97754-1802

Phone

(541) 383-3005

NPI assigned

Dec 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Hayden Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mosaic Community Health

  • Federally Qualified Health Center (FQHC)
  • Prineville, OR
  • NPI 1083633184
  Care Compare group

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1629433206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "018 SW BOUNDARY CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393939",
            "telephone_number": "503-222-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 NW BEAVER ST STE 101",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541802",
            "telephone_number": "541-383-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JESSICA",
        "credential": "CSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HAYDEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Angela Ostby
• Joe Panelli, PA-C
• Courtney Anne Parchmon, LPC, CADCI
• William Michael Pasiechnik
• Gina Peach, FNP
• Page Pedder
• Duane Perrin
• Wendy Perrin, RN
• Carmen Peters
• James G Petersen, DMD,P.C.

• Social Worker in Prineville, OR
• Providers in Prineville, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.

Verify at the official NPI Registry.