Individual provider Active NPI

Jillian Peyerk

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1700370707
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801099989 Issued in MI
Practice address
1090 N 10TH St Ste 110
Kalamazoo, MI 49009-5733
Phone
(989) 980-6235
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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 6801099989 MI Primary

Addresses

Primary practice location

1090 N 10TH St Ste 110
Kalamazoo, MI 49009-5733

Mailing address

1090 N 10TH St Ste 110
Kalamazoo, MI 49009-5733
Phone (989) 980-6235

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200304000895 MI Practitioner - Clinical Social Worker 3072940048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

650 Trade Centre Way
Suite 140
Portage, MI 49002-0411
Phone (517) 882-3732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Mar 22, 2020 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Nov 7, 2023 Accepting new patients
Ascension Medical Group Promed Current Accepting new patients
Ascension Medical Group Promed CurrentSince Mar 22, 2020 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Nov 7, 2023 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

650 Trade Centre Way
Ste 140
Portage, MI 49002
Phone (269) 492-6636

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

7895 Currier Dr
Portage, MI 49002
Phone (269) 321-7120

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1700370707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST STE 110",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "989-980-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST STE 110",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "989-980-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYERK",
        "first_name": "JILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.