Kimberly Peacock, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34.012512 Issued in OH

Practice address

15105 Saint Clair Ave
Cleveland, OH 44110-3719

Phone

(216) 800-8020

Fax

(216) 231-7920

NPI assigned

May 20, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Northeast Ohio Neighborhood Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1851302665
  Medicare reassignment NPD
• Dedicated Ohio Holding LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1922631019

  OH

  Medicare reassignment NPD
• Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1508877739
  NPD
• Northeast Ohio Neighborhood Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1659194595
  NPD
• Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1952417891
  NPD

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1235541665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103719",
            "telephone_number": "216-800-8020",
            "fax_number": "216-231-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15105 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103719",
            "telephone_number": "216-800-8020",
            "fax_number": "216-231-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "KIMBERLY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.012512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace by Piece Cleveland
• Peaceful Counseling LLC
• Joseph Peachman, A.A.
• Candace Peacock
• Erica Peacock, STNA
• Tomeakan Renee Peak
• Alexandra Pearce, MD
• Niki A Pearce, CNM
• Pearl Academy, Inc.
• Pearl Road Chiropractic, Inc

• Family Medicine Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.