PETER J NINEMIRE (LSCSW, LCAC) – Clinical Social Worker, NPI 1790933943

PETER J NINEMIRE (LSCSW, LCAC) is a healthcare provider. based in Wichita, Kansas. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LSCSW, LCAC. They hold a License No. 344 (KS). The NPI Number for PETER J NINEMIRE (LSCSW, LCAC) is 1790933943

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
PETER J NINEMIRE (LSCSW, LCAC)
NPI
1790933943
Phone
(316) 295-4800
Address
714 S HILLSIDE ST
Enumeration Date
29 August 2008
Last Update Date
12 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3162954800
Graduation Year
2006 (20 years ago)
PAC ID
0941362719
Group Practice PAC ID
3173837861
Professional Enrollment ID
I20090105000147
Address ID
KS672113002WI714XXSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:17State licenses:3Digital endpointsOther names

833 CLINICAL SOCIAL WORKER in KS

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Provider Addresses for PETER J NINEMIRE (LSCSW, LCAC)

  • 714, South Hillside Street, Mead Neighborhood, Wichita, Sedgwick County, Kansas, 67211, United States

    WICHITA, KS 672113002

    Phone: (316) 295-4800

    Fax: (316) 295-4811

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-01-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090105000147IClinical Social WorkerKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67211)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173837861View full group profile
NameSpecialtyState
-KS
Clinical Social WorkerKS

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Frequently asked questions

Is there an official ID for PETER J NINEMIRE (LSCSW, LCAC) in U.S. healthcare records?
The official identifier for PETER J NINEMIRE (LSCSW, LCAC) is NPI 1790933943.
Is PETER J NINEMIRE (LSCSW, LCAC) shown as active in public data?
Registry records indicate PETER J NINEMIRE (LSCSW, LCAC) maintains an active NPI.
What clinical focus is listed for PETER J NINEMIRE (LSCSW, LCAC)?
At a glance, PETER J NINEMIRE (LSCSW, LCAC) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in Kansas is PETER J NINEMIRE (LSCSW, LCAC) registered?
Use Wichita, Kansas as the headline location for PETER J NINEMIRE (LSCSW, LCAC) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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