Michael L Peck

Primary specialty

OptometristTaxonomy code 152W00000X

License

1058 Issued in OK

Legal business name

MICHAEL L PECK

Practice address

517 W Maine Ave
Enid, OK 73701-5542

Phone

(580) 242-2300

Fax

(580) 233-7370

NPI assigned

Oct 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael L Peck, O.D.

Title

Optometrist

Phone

(580) 242-2300

Specialties & licenses 2

Addresses

Other identifiers 5

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin Lee Funk, O.D.

  • Optometrist
  • Enid, OK
  • NPI 1336427178
  NPD (past)
• Terresa R Harrington, OD

  • Optometrist
  • Norman, OK
  • NPI 1629029988
  NPD (past)
• Clint McKinley Sproul, O.D.

  • Optometrist
  • Enid, OK
  • NPI 1851672323
  NPD (past)

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1306034830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 W MAINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015542",
            "telephone_number": "580-242-2300",
            "fax_number": "580-233-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 W MAINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015542",
            "telephone_number": "580-242-2300",
            "fax_number": "580-233-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L PECK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "580-242-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1058",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "1058",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEICARE",
            "identifier": "410001137",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DA7479",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "800522342",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765010B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHEILD",
            "identifier": "730794467004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Rose Messenger, APRN
• Dia Janae Metcalf
• Teresa Meyer
• MG Miller-Management & Holding LTD Co
• Michael G. Nolen M.D. PLLC
• Connor Mihoulides
• Mike Nicholas, O.D. Inc.
• Charles Phillip Miles
• John Emmet Miles, M.D.
• Millennium Community Services LLC

• Optometrist in Enid, OK
• Providers in Enid, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.