Johnathan W Peck, DMS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117435 Issued in FL

Practice address

607 S Broadway
Coweta, OK 74429-5000

Phone

(918) 486-5564

NPI assigned

Jan 10, 2023

Last updated

Feb 12, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Arkansas Verdigris Valley Health Centers, Inc.Group PAC ID 2961594916, shared by 4 NPIs, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Merit-based Incentive Payment System (MIPS)

Final score

85.89 of 100Reported as group

Quality

73.2

Promoting interoperability

100

Improvement activities

40

Cost

79.78

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13866/brand/1/csg/1/fhir/r4
• Direct secure messaging: johnathan.peck.1@25507.direct.athenahealth.com
• Direct secure messaging: johnathan.peck.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  Medicare reassignment Care Compare group
• Arkansas Verdigris Valley Health Centers, Inc.

  • Family Medicine Physician
  • Porter, OK
  • NPI 1083740047
  Medicare reassignment NPD
• Elizabeth Muddiman Cefalu MD MPH PLLC

  • Internal Medicine Physician
  • North Port, FL
  • NPI 1154707180
  Medicare reassignment
• Arkansas Verdigris Valley Health Centers, Inc.

  dba Coweta Health Center

  • Family Medicine Physician
  • Coweta, OK
  • NPI 1346712072
  NPD

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

• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1144934589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S BROADWAY",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744295000",
            "telephone_number": "918-486-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S BROADWAY",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744295000",
            "telephone_number": "918-486-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JOHNATHAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117435",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Osu Center for Health Sciences (Osu-Aj Warren Clinic Pediatrics Coweta)
• Jill Leigh Overhuls
• Sandra Parke, AU D
• Barry Ray Parkerson
• Jackie J Parnell, PA
• Kala Perez, M.S. M.ED.
• Ashley Anne Petersen, M.D.
• Kasey Pierce, PHARMD
• Dejuan Powell
• Premier Dental

• Physician Assistant in Coweta, OK
• Providers in Coweta, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.