Individual provider Active NPI

Viktoria Ellen Peck, RN

  • Registered Nurse
  • Troy, OH
National Provider Identifier
1063837862
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
317230 Issued in OH
Practice address
990 Oak Lea Dr
Troy, OH 45373-9536
Phone
(937) 477-5230
NPI assigned
Mar 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 317230 OH Primary

Addresses

Primary practice location

990 Oak Lea Dr
Troy, OH 45373-9536

Mailing address

990 Oak Lea Dr
Troy, OH 45373-9536
Phone (937) 477-5230

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
317230OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1063837862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 OAK LEA DR",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453739536",
            "telephone_number": "937-477-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 OAK LEA DR",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453739536",
            "telephone_number": "937-477-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "VIKTORIA",
        "middle_name": "ELLEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "317230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.