Individual provider Active NPI

Vicky Peterkin

  • Clinical Social Worker
  • Florence, SC
National Provider Identifier
1992812655
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8271 Issued in SC
Practice address
360 N Irby St
Florence, SC 29501-2808
Phone
(843) 667-9414
Fax
(843) 667-1362
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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 8271 SC Primary

Addresses

Primary practice location

360 N Irby St
Florence, SC 29501-2808

Mailing address

360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414

Other identifiers 1

IdentifierTypeStateIssuer
SW1105MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050217000456 SC Practitioner - Clinical Social Worker 8123070158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of South Carolina School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanders Family Counseling, LLCGroup PAC ID 6800049594, 4 clinicians

Practice addresses (Care Compare)

2147 Hoffmeyer Rd
Florence, SC 29501-4015
Phone (843) 960-2050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8271SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hopehealth Inc Current Accepting new patients
Hopehealth, Inc CurrentSince Sep 27, 2021 Accepting new patients
Hopehealth Inc CurrentSince Sep 27, 2021 Accepting new patients
Sanders Family Counseling LLC Clinical CurrentSince Oct 25, 2021 Accepting new patients

Locations

2147 Hoffmeyer Rd
Florence, SC 29501
Phone (843) 661-6030

360 N Irby St
Florence, SC 29501
Phone (843) 656-0353

600 E Palmetto St
Florence, SC 29506
Phone (843) 656-0390

Interoperability endpoints

  • Direct secure messaging: vicky.peterkin@hop.eclinicaldirectplus.com

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1992812655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "VICKY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1105",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.