Pecks Family Practice PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME71672 Issued in FL

Legal business name

PECKS FAMILY PRACTICE PLC

Practice address

1688 W Granada Blvd
Ste 2a
Ormond Beach, FL 32174-1851

Phone

(386) 677-2018

Fax

(386) 676-0737

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Benjamin Jay Peck, MD

Title

Owner

Phone

(386) 677-2018

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1164528915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 W GRANADA BLVD",
            "address_2": "STE 2A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741851",
            "telephone_number": "386-677-2018",
            "fax_number": "386-676-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1688 W GRANADA BLVD",
            "address_2": "STE 2A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741851",
            "telephone_number": "386-677-2018",
            "fax_number": "386-676-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECKS FAMILY PRACTICE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-677-2018",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME71672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA1617",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271555400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLODIDA",
            "identifier": "34648",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geertrui Peeters, OTR

• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.