Jayne Ellen Peak, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP7967 Issued in AZ

Practice address

9900 Bren Road East
Mail Route MN 008-B213
Minnetonka, MN 55343

Phone

(800) 561-0861

Fax

(563) 421-3129

NPI assigned

Jun 2, 2005

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

Other identifiers 4

Other names 1

• Mrs. Jayne Ellen Gilmore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Health Care, Inc.

  • Clinical Medical Laboratory
  • Davenport, IA
  • NPI 1649461310
  NPD
• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274
  NPD (past)
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD (past)

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1104828276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17015 N. 130TH AVE",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "85375",
            "telephone_number": "309-269-3162",
            "fax_number": "563-421-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN ROAD EAST",
            "address_2": "MAIL ROUTE MN 008-B213",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "800-561-0861",
            "fax_number": "563-421-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAK",
        "first_name": "JAYNE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA MIDLANDS CHOICE",
            "identifier": "15939",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "03262",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1583450",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2583450",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYNE",
            "last_name": "GILMORE",
            "middle_name": "ELLEN",
            "prefix": "MRS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rose M Paz, ARNP
• PDG, P.a.
• PDG,P.a.
• Peak Performance Chiropractic
• Peak Potential Family Chiropractic PLLC
• Charles Pearson, MD
• Elizabeth Joanne Pearson, MAOT
• Kaylee Marie Pearson, LGSW
• Mary Jane Pearson, MSW, LICSW
• Benjamin Pease III

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.