Active NPI
Peaches Wilson
- Clinical Social Worker
- Germantown, MD
National Provider Identifier
1881050615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16535
- Practice address
- 19801 Observation Dr
Germantown, MD 20876-4070 - Phone
- (301) 557-6000
- NPI assigned
- Jan 8, 2016
- Last updated
- Jan 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16535 | MD | Primary |
Addresses
Primary practice location
19801 Observation Dr
Germantown, MD 20876-4070
Mailing address
8308 McCullough LN Apt 303
Gaithersburg, MD 20877-1125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16535 | MD | MD | Clinical Social Worker |
Organizations & group practices 1
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.
-
- Health Service Clinic/Center
- Silver Spring, MD
- NPI 1487692828
DC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1881050615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8308 MCCULLOUGH LN APT 303",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208771125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19801 OBSERVATION DR",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764070",
"telephone_number": "301-557-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "PEACHES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-08",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.