Jordan Nicholas Peacock, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111816 Issued in FL

Practice address

1110 Airport Blvd
Suite B
Pensacola, FL 32504

Phone

(850) 438-1136

NPI assigned

Sep 29, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

University of South Alabama College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald Coast Center for Neurological DisordersGroup PAC ID 2062417215, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peoples Home Health LLC Home health agency, Pensacola, FL, CCN 109664
• Amedisys Home Health Home health agency, Pensacola, FL, CCN 108309
• Baptist Hospital Hospital, Pensacola, FL, CCN 100093
• Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: j.peacock@eccnd.directbygreenway.com

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.

• Emerald Coast Center for Neurological Disorders

  • Neurology Physician
  • Pensacola, FL
  • NPI 1750315701
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Florida, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Pensacola, FL
  • NPI 1679685085
  Care Compare affiliation
• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  Care Compare affiliation
• Baptist Health Care, Inc.

  dba Gulf Breeze Hospital

  • General Acute Care Hospital
  • Gulf Breeze, FL
  • NPI 1972664530
  Care Compare affiliation
• Peoples Home Health LLC

  • Home Health Agency
  • Pensacola, FL
  • NPI 1801931837
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1033628326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 AIRPORT BLVD",
            "address_2": "SUITE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 AIRPORT BLVD",
            "address_2": "SUITE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32504",
            "telephone_number": "850-438-1136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Creighton Rd Apt I3",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325044631",
            "country_code": "US",
            "telephone_number": "918-351-3706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3719 Dauphin St",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366081753",
            "country_code": "US",
            "telephone_number": "251-460-5333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JORDAN",
        "middle_name": "NICHOLAS",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA-1279",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Payne
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• Patrea Payne, NP
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• Melanie Joy Peacher, LDN
• Abagayle Grace Peaden, BSN, RN
• Peaklife Medical Group LLC
• Gina-Marie Pearce, CNM ARNP
• Hali Nicole Pearce, DO
• James C. Pearce Jr., PTA

• Physician Assistant in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.