Sonja Elaine Peckham, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

12655NP Issued in OH

Practice address

7580 Auburn Rd
Suite 207
Concord TWP, OH 44077-9615

Phone

(440) 354-1802

Fax

(440) 953-6138

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

Yes

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

Enrolled in OH

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

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Health Hospital, Concord, OH, CCN 360098

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: speckham28116@ehrdirect.uhhospitals.org

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.

• Lake Hospital System Inc

  • Family Medicine Physician
  • Middlefield, OH
  • NPI 1952339996
  Medicare reassignment Care Compare group NPD
• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  Medicare reassignment Care Compare group NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  OH

  Medicare reassignment NPD
• Lake Hospital System Inc

  • Obstetrics & Gynecology Physician
  • Willoughby Hills, OH
  • NPI 1699719518
  NPD
• Lake Hospital System, Inc

  • Urgent Care Clinic/Center
  • Madison, OH
  • NPI 1134189376
  NPD (past)

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

• Lake Hospital System Inc

  • General Acute Care Hospital
  • Willoughby, OH
  • NPI 1972689172
  Care Compare affiliation

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1114201522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 AUBURN RD",
            "address_2": "SUITE 207",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779615",
            "telephone_number": "440-354-1802",
            "fax_number": "440-953-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 AUBURN RD",
            "address_2": "SUITE 207",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779615",
            "telephone_number": "440-354-1802",
            "fax_number": "440-953-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "SONJA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "12655NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Oddis
• Ohio Permanente Medical Group
• Jacqueline Owens, RN
• Stanley Carter Pace, MD
• Paul F Vanek Jr M D Inc
• Susan Perdue Schultz, CNP
• Julie Pokersnik, M.D.
• Kerry Anne Rihtar, WAIVER PROVIDER
• Ronald Ross, P.T.
• Jeffery Michael Salerno, D.D.S.

• Adult Health Nurse Practitioner in Concord TWP, OH
• Providers in Concord TWP, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.