Kirsten Marie Petron, LCSW, CDC II

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

213013 Issued in AK

Practice address

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

Phone

(907) 631-7670

NPI assigned

Jun 12, 2020

Last updated

Jul 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southcentral FoundationGroup PAC ID 5496663627, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Southcentral Foundation

  dba BSD - McGrath

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McGrath, AK
  • NPI 1780614263

  TX

  Medicare reassignment Care Compare group NPD
• Southcentral Foundation

  dba BH 1115- Benteh Nuutah Primary Care Center

  • Community/Behavioral Health Agency
  • Wasilla, AK
  • NPI 1003469719
  NPD
• Karuna Counseling, LLC

  • Professional Counselor
  • Anchorage, AK
  • NPI 1265196927
  NPD (past)
• Mat - Su Health Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wasilla, AK
  • NPI 1184725210
  NPD (past)

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1902421118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S KNIK GOOSE BAY RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548083",
            "telephone_number": "307-631-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S KNIK GOOSE BAY RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548083",
            "telephone_number": "907-631-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRON",
        "first_name": "KIRSTEN",
        "middle_name": "MARIE",
        "credential": "LCSW, CDC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "3155",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "213013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Peterson, MD
• Laura Jean Peterson, M.D.
• Rebecca Lee Peterson
• Sarah Michelle Peterson
• Scott W Peterson, PA
• Christopher Orion Petruska
• John Jules Petty
• William C Petty
• Pharmacy Partners, LLC (Our Doctor's Pharmacy)
• Pharmacy Partners, LLC (Our Doctor's Pharmacy)

• Clinical Social Worker in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.