Individual provider Active NPI

Amanda L Zeppa, LCSW

  • Clinical Social Worker
  • Wasilla, AK
National Provider Identifier
1750679924
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105666 Issued in AK
Practice address
7010 E Bogard Rd
Wasilla, AK 99654-4711
Phone
(907) 373-4732
NPI assigned
Jul 21, 2011
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 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 105666 AK Primary

Addresses

Primary practice location

7010 E Bogard Rd
Wasilla, AK 99654-4711

Mailing address

PO Box 876741
Wasilla, AK 99687-6741
Phone (907) 373-4732

Other practice location 1

7335 Palmer Wasilla Highway
Palmer, AK 99645
Phone (907) 373-4732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20200826001675 AK Practitioner - Clinical Social Worker 4486071172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105666AKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Set Free Alaska, Inc. CurrentSince Nov 24, 2019 Accepting new patients
Set Free Alaska, Inc. CurrentSince May 19, 2020 Accepting new patients
Set Free Alaska, Inc. CurrentSince May 19, 2020 Accepting new patients

Organizations & group practices 3

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1750679924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 876741",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996876741",
            "telephone_number": "907-373-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996544711",
            "telephone_number": "907-373-4732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7335 Palmer Wasilla Highway",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "99645",
            "country_code": "US",
            "telephone_number": "907-373-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEPPA",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "105666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.