Rebecca Ann Peacock, PT, MPT, ATP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1114700 Issued in TX

Practice address

117 Northern Star
Bruceville, TX 76630-3282

Phone

(254) 857-9961

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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.

• PT Care Specialists LLC

  dba Physical Therapy Care Of Fort Bend

  • Physical Therapy Clinic/Center
  • Richmond, TX
  • NPI 1396319836

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1265653794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 JACKSON ST",
            "address_2": "STE 400",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693250",
            "telephone_number": "281-344-8900",
            "fax_number": "281-344-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NORTHERN STAR",
            "city": "BRUCEVILLE",
            "state": "TX",
            "postal_code": "766303282",
            "telephone_number": "254-857-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT, MPT, ATP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1114700",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "TX",
            "license": "1114700",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1114700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Michelle Donnell, LVN
• Amanda Lynn Durdin, B.A., BCABA
• Happy Kids Autism Intervention Services
• Clayton Andrew Rabbe, PA-C
• Patricia Suzanne Stewart, BCBA
• Dawn Rene Tye

• Physical Therapist in Bruceville, TX
• Providers in Bruceville, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.