Active NPI
Will Peck, PHARM.D.
- Pharmacist
- Alexandria, VA
National Provider Identifier
1255680849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202211730
- Practice address
- 3101 Jefferson Davis Hwy
Alexandria, VA 22305-3042 - Phone
- (703) 706-3852
- NPI assigned
- Aug 29, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202211730 | VA | Primary |
| Pharmacist | 183500000X | 20923 | MD |
Addresses
Primary practice location
3101 Jefferson Davis Hwy
Alexandria, VA 22305-3042
Mailing address
4801 Kenmore Avenue #622
Alexandria, VA 22304
Phone (734) 678-1965
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20923 | MD | MD | Pharmacist |
| 0202211730 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| Virginia CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1255680849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 KENMORE AVENUE #622",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22304",
"telephone_number": "734-678-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 JEFFERSON DAVIS HWY",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223053042",
"telephone_number": "703-706-3852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "WILL",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202211730",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "20923",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.