AHC-OTTAWA ELEMENTARY SCHOOL — NPI 1164970307 (Licensed & Credentialed Social Worker, School in PETOSKEY, MI)

CMS-1500 Box 24J / 33a • NPI

1164970307

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1041S0200X

Licensed & Credentialed Social Worker, School

Box 32 Service Location & ZIP+4

871 KALAMAZOO AVE, PETOSKEY, MI, 49770-3216

✓ 9-Digit EDI 837 ZIP+4 (49770-3216)

Practice Phone & Referral Fax

(231) 348-2130

Fax: (231) 348-2302

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1164970307 (AHC-OTTAWA ELEMENTARY SCHOOL) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1164970307` (NPI-2 Organization / Facility)
Provider / Legal Name	AHC-OTTAWA ELEMENTARY SCHOOL
Plain-English Specialty	Licensed & Credentialed Social Worker, School NUCC Code: `1041S0200X` (Social Worker, School)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	871 KALAMAZOO AVE, PETOSKEY, MI, 49770-3216
Practice Telephone / Fax	Tel: (231) 348-2130 \| Fax: (231) 348-2302
Administrative Mailing Address	1035 W WASHINGTON AVE, ALPENA, MI, 49707-2929
Enumeration & Last Sync	Enumerated: 2016-09-16 \| CMS Record Updated: 2026-01-12
Authorized Official	NANCY SPENCER (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

871 KALAMAZOO AVE, PETOSKEY, MI, 49770-3216

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Plain-English Taxonomy & CMS Crosswalk (1041S0200X)

What Does Taxonomy Code 1041S0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041S0200X translates to:
"Licensed & Credentialed Social Worker, School"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker, School for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AHC-OTTAWA ELEMENTARY SCHOOL)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QF0400X` — Clinic/Center, Federally Qualified Health Center (FQHC) Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`101YS0200X` — Counselor, School Plain English: Licensed & Credentialed Counselor, School	State: N/A \| License: `Verified` \| Primary: Secondary
`1041S0200X` — Social Worker, School Plain English: Licensed & Credentialed Social Worker, School	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AHC-OTTAWA ELEMENTARY SCHOOL (NPI #1164970307)