Active NPI
Dana Peacock
- Physical Therapist
- Macomb, IL
National Provider Identifier
1285412015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070027489
- Practice address
- 525 E Grant St
Macomb, IL 61455-3318 - Phone
- (309) 836-1601
- NPI assigned
- Sep 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070027489 | IL | Primary |
Addresses
Primary practice location
525 E Grant St
Macomb, IL 61455-3318
Mailing address
181 S Douglas St
Carthage, IL 62321-1700
Phone (573) 822-2472
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070027489 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1285412015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 S DOUGLAS ST",
"city": "CARTHAGE",
"state": "IL",
"postal_code": "623211700",
"telephone_number": "573-822-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 E GRANT ST",
"city": "MACOMB",
"state": "IL",
"postal_code": "614553318",
"telephone_number": "309-836-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "DANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070027489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macomb, IL
- Patricia Lee Pasquesi-Nemec, SLP
- Richard W Passmore, DDS
- Prayag Naineshkumar Patel, MD
- Theodore James Pawlias, D.D.S.
- Lindsay J Peachey, N.C.C.
- Pediatric Therapy Services of Macomb, LLC
- Rachel Ellen Pelton
- Michael Patrick Pendergast Sr., ATC
- Petersen Health Operations, LLC
- Petersen Health Properties, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.