Individual provider Active NPI

Bianca F Peck, APRN

  • Family Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1013696160
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11027492 Issued in FL
Practice address
438 W Brevard St
Tallahassee, FL 32301-1004
Phone
(850) 759-0366
Fax
(833) 449-3559
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11027492 FL Primary

Addresses

Primary practice location

438 W Brevard St
Tallahassee, FL 32301-1004

Mailing address

438 W Brevard St
Tallahassee, FL 32301-1004
Phone (850) 759-0366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230825001203 FL Practitioner - Nurse Practitioner 6305209255 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11027492FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wakulla Urgent Care & Diagnostic Center PLC CurrentSince Jul 1, 2023 Accepting new patients
Wakulla Urgent Care & Diagnostic Center PLC CurrentSince Jul 26, 2023 Accepting new patients
Neighborhood Medical Center, Inc Past Accepting new patients

Locations

41 Feli Way
Crawfordville, FL 32327
Phone (850) 879-7831

Interoperability endpoints

  • Direct secure messaging: bianca.peck.1@29290.direct.athenahealth.com
  • Direct secure messaging: bianca.peck.1@15524.direct.athenahealth.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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1013696160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 W BREVARD ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323011004",
            "telephone_number": "850-759-0366",
            "fax_number": "833-449-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W BREVARD ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323011004",
            "telephone_number": "850-759-0366",
            "fax_number": "833-449-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "BIANCA",
        "middle_name": "F",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.