Individual provider Active NPI

Jennifer A Peters, LISW-S

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1669988440
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0008967 Issued in OH
Practice address
1490 E Main St
Columbus, OH 43205-2140
Phone
(614) 252-0731
NPI assigned
Dec 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0008967 OH Primary

Addresses

Primary practice location

1490 E Main St
Columbus, OH 43205-2140

Mailing address

5555 Waterloo Rd
Canal Winchester, OH 43110-9542
Phone (614) 395-5160

Other practice location 1

5665 Hoover Rd
Grove City, OH 43123-9122
Phone (614) 875-2371

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

LicenseStateTypeSpecialty
I-0008967OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1513382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1669988440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 WATERLOO RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109542",
            "telephone_number": "614-395-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052140",
            "telephone_number": "614-252-0731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5665 Hoover Rd",
            "address_purpose": "LOCATION",
            "city": "Grove City",
            "state": "OH",
            "postal_code": "431239122",
            "country_code": "US",
            "telephone_number": "614-875-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-16",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0008967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.

Verify at the official NPI Registry.