AHC-PETOSKEY HIGH SCHOOL — NPI 1629526868 (Licensed & Credentialed Social Worker, School in PETOSKEY, MI)

CMS-1500 Box 24J / 33a • NPI

1629526868

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1041S0200X

Licensed & Credentialed Social Worker, School

Box 32 Service Location & ZIP+4

1500 HILL ST, PETOSKEY, MI, 49770-2782

✓ 9-Digit EDI 837 ZIP+4 (49770-2782)

Practice Phone & Referral Fax

(231) 348-3160

Fax: (231) 348-2161

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1629526868 (AHC-PETOSKEY HIGH 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	`1629526868` (NPI-2 Organization / Facility)
Provider / Legal Name	AHC-PETOSKEY HIGH 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	1500 HILL ST, PETOSKEY, MI, 49770-2782
Practice Telephone / Fax	Tel: (231) 348-3160 \| Fax: (231) 348-2161
Administrative Mailing Address	1500 HILL ST, PETOSKEY, MI, 49770-2782
Enumeration & Last Sync	Enumerated: 2016-09-16 \| CMS Record Updated: 2016-09-16
Authorized Official	CHRISTINE BAUMGARDNER (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1500 HILL ST, PETOSKEY, MI, 49770-2782

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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-PETOSKEY HIGH 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
`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-PETOSKEY HIGH SCHOOL (NPI #1629526868)