Michelle Baisden Peck

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN23943 Issued in TN

Practice address

7714 Conner Rd Ste 101
Powell, TN 37849-3559

Phone

(865) 212-6441

Fax

(865) 212-6446

NPI assigned

Apr 9, 2018

Sex

Female

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)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EFACCD/Endpoint/EFACCD

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.

• Blackmon Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Powell, TN
  • NPI 1437167194
  NPD (past)

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1053818922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 CONNER RD STE 101",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493559",
            "telephone_number": "865-212-6441",
            "fax_number": "865-212-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7714 CONNER RD STE 101",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493559",
            "telephone_number": "865-212-6441",
            "fax_number": "865-212-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MICHELLE",
        "middle_name": "BAISDEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN23943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli L Patrick, FNP
• Jean Simms Patterson, LCSW
• Carrie Sexton Payne, CRNA
• Katherine Payne
• Madison Ashby Payne
• Pediatric Dentistry PC
• Fred Neal Peebles, M.D.
• Carolyn E Pendergast, OT
• Erica Jaquise Peppers, MPH, B.A.
• Monica Perry, O.D.

• Pediatric Nurse Practitioner in Powell, TN
• Providers in Powell, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.