Individual provider Active NPI

David B Peck, PA

  • Physician Assistant
  • Westminster, MD
National Provider Identifier
1114940392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0000820 Issued in MD
Practice address
200 Memorial Avenue
Carroll Hospital Center
Westminster, MD 21157-5799
Phone
(410) 871-6700
Fax
(410) 871-7177
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0000820 MD Primary

Addresses

Primary practice location

200 Memorial Avenue
Carroll Hospital Center
Westminster, MD 21157-5799

Mailing address

1300 Piccard Drive
Suite 202
Rockville, MD 20850-4303
Phone (301) 921-7900

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0000820MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Critical Care Services,L.L.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114940392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PICCARD DRIVE",
            "address_2": "SUITE 202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504303",
            "telephone_number": "301-921-7900",
            "fax_number": "301-921-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEMORIAL AVENUE",
            "address_2": "CARROLL HOSPITAL CENTER",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575799",
            "telephone_number": "410-871-6700",
            "fax_number": "410-871-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0000820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.