Daniel Peckenpaugh, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

F7040 Issued in TX

Practice address

1545 E Southlake Blvd
Southlake, TX 76092-6422

Phone

(817) 748-8700

NPI assigned

Feb 23, 2006

Last updated

Nov 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southlake Emergicare PLLC

  • Emergency Medicine Physician
  • Southlake, TX
  • NPI 1598172033
  Authorized official Same address or phone
• Heb Emergicare PA

  • Emergency Medicine Physician
  • Bedford, TX
  • NPI 1306812193
  NPD (past)

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1053387829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720508",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704373",
            "telephone_number": "877-485-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926422",
            "telephone_number": "817-748-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKENPAUGH",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "F7040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PDH Corporation (Pur Life Medical Southlake)
• Peace Psychology Center PLLC
• Peak Physical Therapy, LLC
• Erica Jean Pearson, DC
• Amber Peck, P.T.
• Pediaplex Management Company LLC
• Pediatric Ambulatory Surgery Center Southlake
• Pediatric Speech Stars, PLLC
• Caitlin Elizabeth Pedigo, RNFA
• William Robert Peeler

• Emergency Medicine Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.