Marc Peck

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1706 Wayne Memorial Dr
Goldsboro, NC 27534-2240

Phone

(919) 734-6676

Fax

(919) 734-9050

NPI assigned

Jan 24, 2014

Sex

Male

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 NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Waynesboro Family Clinic

  • Mental Health Counselor
  • Goldsboro, NC
  • NPI 1760417570
  Medicare reassignment NPD
• Wayne Cares Inc.

  • Voluntary or Charitable Agency
  • Goldsboro, NC
  • NPI 1518414465
  NPD (past)

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1235552365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342240",
            "telephone_number": "919-734-6676",
            "fax_number": "919-734-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342240",
            "telephone_number": "919-734-6676",
            "fax_number": "919-734-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MARC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nilima Patel, FNP-C
• Niyati Shyam Patel, DO
• Shreyang Hemonsuroy Patel, MD
• Allison Paugh, PMHNP
• Nakia Pearson, CSAC-R. CPSS
• Pediatric Play Therapy, LLC
• Hector Manuel Pedraza, M.D.
• Connie Pender, PHARMD
• Krystal Ann Pendergraft
• Christian Penister

• Addiction (Substance Use Disorder) Counselor in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.