NPIMap

Organization Active NPI

Joyce C Peck

  • Eyewear Supplier
  • Maysville, KY
National Provider Identifier
1225166895
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
2826372 Issued in KY
Legal business name
JOYCE C PECK
Practice address
1937 Old Main St
Ste 2
Maysville, KY 41056-8956
Phone
(606) 759-7311
Fax
(606) 759-0610
NPI assigned
Mar 2, 2007
Last updated
Jan 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Authorized official

Name
Joyce C PeckNPI 1427041037
Title
Optician
Phone
(606) 564-8794

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 079545 KY
Eyewear Supplier 332H00000X 2826372 KY Primary
Optician 156FX1800X 941 KY

Addresses

Primary practice location

1937 Old Main St
Ste 2
Maysville, KY 41056-8956

Mailing address

PO Box 54
Washington, KY 41096-0054
Phone (606) 564-8794

Other identifiers 8

IdentifierTypeStateIssuer
4296MedicaidKY
5290396000MedicaidKY
000000537045OtherKYBCBS
4295MedicaidKY
5200016300MedicaidKY
5280097600MedicaidKY
5200015500MedicaidKY
7100022560MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1225166895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "WASHINGTON",
            "state": "KY",
            "postal_code": "410960054",
            "telephone_number": "606-564-8794",
            "fax_number": "606-759-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 OLD MAIN ST",
            "address_2": "STE 2",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568956",
            "telephone_number": "606-759-7311",
            "fax_number": "606-759-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOYCE C PECK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "606-564-8794"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "079545",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "2826372",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4296",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5290396000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000537045",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4295",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200016300",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5280097600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200015500",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100022560",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.