Individual provider Active NPI

Peter J Ninemire, LSCSW, LCAC

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1790933943
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4326 Issued in KS
Practice address
714 S Hillside St
Wichita, KS 67211-3002
Phone
(316) 295-4800
Fax
(316) 295-4811
NPI assigned
Aug 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 344 KS
Addiction (Substance Use Disorder) Counselor 101YA0400X
Social Worker 104100000X 6503 KS
Clinical Social Worker 1041C0700X 4326 KS Primary

Addresses

Primary practice location

714 S Hillside St
Wichita, KS 67211-3002

Mailing address

714 S Hillside St
Wichita, KS 67211-3002
Phone (316) 295-4800

Other identifiers 1

IdentifierTypeStateIssuer
200570410CMedicaidKS

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
I20090105000147 KS Practitioner - Clinical Social Worker 0941362719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Caring Center of Wichita LLCGroup PAC ID 3173837861, 3 clinicians

Practice addresses (Care Compare)

714 S Hillside St
Wichita, KS 67211-3002
Phone (316) 295-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
344KSMDProfessional Counselor
6503KSMDSocial Worker
4326KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Caring Center of Wichita, LLC Addiction (Substance Use Disorder) CurrentSince May 30, 2015 Accepting new patients
The Caring Center of Wichita, LLC Current Accepting new patients
Peter Ninemire Counseling Addiction (Substance Use Disorder) PastSince Feb 28, 2012 Accepting new patients
Peter Ninemire Counseling Addiction (Substance Use Disorder) PastSince Feb 28, 2012 Accepting new patients

Locations

714 S Hillside St
Wichita, KS 67211
Phone (316) 295-4800

Organizations & group practices 4

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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1790933943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672113002",
            "telephone_number": "316-295-4800",
            "fax_number": "316-295-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672113002",
            "telephone_number": "316-295-4800",
            "fax_number": "316-295-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINEMIRE",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "LSCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "344",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "6503",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200570410C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.