Active NPI
Howard Peschke, DPM
- Podiatrist
- Southgate, MI
National Provider Identifier
1013023092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 5901400131
- Practice address
- 13308 Edison St
Southgate, MI 48195-1076 - Phone
- (734) 282-4300
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 5901400131 | MI | Primary |
Addresses
Primary practice location
13308 Edison St
Southgate, MI 48195-1076
Mailing address
13308 Edison St
Southgate, MI 48195-1076
Phone (734) 282-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4384847 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1013023092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13308 EDISON ST",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481951076",
"telephone_number": "734-282-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13308 EDISON ST",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481951076",
"telephone_number": "734-282-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESCHKE",
"first_name": "HOWARD",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "5901400131",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4384847",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.