Peggy Jo Knaack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026045 Issued in IL

Practice address

705 Oaklawn Ave
East Moline, IL 61244-4013

Phone

(309) 737-5676

NPI assigned

Dec 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southpark Psychology LTD

  • Counseling Psychologist
  • Moline, IL
  • NPI 1558470419

  Clinical

  Medicare reassignment Care Compare group NPD
• Advanced Cardiovascular Consultants,SC

  • Specialist
  • Moline, IL
  • NPI 1588718910
  NPD

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1912775537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 OAKLAWN AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612444013",
            "telephone_number": "309-737-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 OAKLAWN AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612444013",
            "telephone_number": "309-737-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAACK",
        "first_name": "PEGGY",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A Kendall, D.M.D
• Amy Kernan
• Kevin C Dodson
• Kevin C. Dodson D.P.M.
• Alexander Edward Kincaid
• Kelsie Knutsen, PT
• Laboratory Corporation of America
• Skylar Larion
• Peggy S Laud
• Alannagh Lee

• Clinical Social Worker in East Moline, IL
• Providers in East Moline, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.