Jason Russell Peck, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

33116 Issued in SC

Practice address

9 Richland Medical Park Dr Ste 530
Columbia, SC 29203-6870

Phone

(803) 434-4603

Fax

(803) 434-3866

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Palmetto Health

  • Pediatric Hospice and Palliative Medicine Physician
  • Columbia, SC
  • NPI 1164796306
  NPD
• Prisma Health-Midlands

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1205889458
  NPD
• Prisma Health-Midlands

  • General Acute Care Hospital
  • Sumter, SC
  • NPI 1326043548
  NPD
• Pediatrix Medical Management Group Inc

  • Neonatal-Perinatal Medicine Physician
  • Colorado Springs, CO
  • NPI 1003830282

  Pediatric Critical Care Medicine

  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1235290693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-269-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR STE 530",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036870",
            "telephone_number": "803-434-4603",
            "fax_number": "803-434-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JASON",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "33116",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L8471",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CO",
            "license": "45451",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "SC",
            "license": "33116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31162",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille E Peay, LPC
• Carolyn Bonaparte Peay
• Morgan Peay
• Frank Pechal, M.D.
• Paula Mae A Pecho
• Pediatria Healthcare, LLC
• Pediatric After Hours Care LLC
• Pediatric Associates, P.a.
• Pediatric Associates, P.a.
• Pediatric Endocrine Specialty

• Pediatric Critical Care Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatric Critical Care Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.