Individual provider Active NPI

Laura Faye Peacock, NP

  • Family Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1144763855
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006726A Issued in IN
Practice address
770 Park East Blvd Ste B
Lafayette, IN 47905
Phone
(765) 714-4344
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006726A IN Primary

Addresses

Primary practice location

770 Park East Blvd Ste B
Lafayette, IN 47905

Mailing address

PO Box 5748
Lafayette, IN 47903-5748

Other practice location 1

440 W Songer Ln
Veedersburg, IN 47987-8547
Phone (765) 762-4180

Other practice location 2

107 S Washington St Ste C
Kokomo, IN 46901-4601
Phone (765) 450-6735

Other practice location 3

412 N Monroe St
Williamsport, IN 47993-1049
Phone (765) 462-7000

Other practice location 4

613 Terrace Dr
Winamac, IN 46996-1111
Phone (574) 946-4290

Other practice location 5

1101 Michigan Ave Ste 30
Logansport, IN 46947-1528
Phone (574) 753-7541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laura.peacock@1346.securemail.prognocis.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20161220000618 IN Practitioner - Nurse Practitioner 4587945134 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulaski Memorial HospitalGroup PAC ID 3173515509, shared by 32 NPIs, 45 clinicians
Lafayette Pain Care, P.C.Group PAC ID 3678728680, 8 clinicians

Practice addresses (Care Compare)

616 E 13TH St
Winamac, IN 46996-1117
Phone (574) 946-2100

770 Park E Blvd B
Lafayette, IN 47905-0786
Phone (765) 714-4344

Hospital & facility affiliations

  • Pulaski Memorial Hospital Hospital, Winamac, IN, CCN 151305
  • Memorial Hospital Hospital, Logansport, IN, CCN 150072
  • Franciscan Health Lafayette Hospital, Lafayette, IN, CCN 150109
  • Northwest Health - Starke Hospital, Knox, IN, CCN 150102
  • Indiana University Health White Memorial Hospital Hospital, Monticello, IN, CCN 151312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulaski Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Lafayette Pain Care, P.C. CurrentSince Sep 18, 2018 Accepting new patients
Pulaski Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Pulaski Memorial Hospital Current Accepting new patients
Lafayette Pain Care PC CurrentSince Sep 18, 2018 Accepting new patients
Pulaski Memorial Hospital Current Accepting new patients
Kokomo Ambulatory Surgery Center Past Accepting new patients

Locations

107 S Washington St
Ste A
Kokomo, IN 46901
Phone (765) 450-6735

107 S Washington St
Ste C
Kokomo, IN 46901
Phone (317) 798-0040

770 Park East Blvd
Ste B
Lafayette, IN 47905
Phone (765) 366-4344

1714 Dividend Dr
Logansport, IN 46947
Phone (574) 739-1776

1101 Michigan Ave
Ste 30
Logansport, IN 46947
Phone (574) 753-7541

707 N River Dr
Marion, IN 46952
Phone (765) 573-5999

1127 N Western Ave
Marion, IN 46952
Phone (765) 661-2994

1207 E Grace St
Rensselaer, IN 47978
Phone (800) 541-8142

412 N Monroe St
Williamsport, IN 47993
Phone (765) 762-2496

525 E 13th St
Winamac, IN 46996
Phone (219) 946-6886

616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100

540 Hospital Dr
Winamac, IN 46996
Phone (574) 935-4327

613 Terrace Dr
Winamac, IN 46996
Phone (574) 946-4290

Interoperability endpoints

  • Direct secure messaging: laura.peacock@4347.securemail.prognocis.com
  • Direct secure messaging: laura.peacock@1346.securemail.prognocis.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1144763855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5748",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PARK EAST BLVD STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47905",
            "telephone_number": "765-714-4344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 W Songer Ln",
            "address_purpose": "LOCATION",
            "city": "Veedersburg",
            "state": "IN",
            "postal_code": "479878547",
            "country_code": "US",
            "telephone_number": "765-762-4180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 S Washington St Ste C",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469014601",
            "country_code": "US",
            "telephone_number": "765-450-6735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "412 N Monroe St",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "IN",
            "postal_code": "479931049",
            "country_code": "US",
            "telephone_number": "765-462-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "613 Terrace Dr",
            "address_purpose": "LOCATION",
            "city": "Winamac",
            "state": "IN",
            "postal_code": "469961111",
            "country_code": "US",
            "telephone_number": "574-946-4290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Michigan Ave Ste 30",
            "address_purpose": "LOCATION",
            "city": "Logansport",
            "state": "IN",
            "postal_code": "469471528",
            "country_code": "US",
            "telephone_number": "574-753-7541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "LAURA",
        "middle_name": "FAYE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006726A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura.peacock@1346.securemail.prognocis.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "770 Park East Blvd Ste B",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "47905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.