Columbia Rheumatology

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD00036578 Issued in WA

Legal business name

COLUMBIA RHEUMATOLOGY

Doing business as

Derek J Peacock MD PLLC

Practice address

512 N Young St
Suite C
Kennewick, WA 99336-7806

Phone

(509) 783-2000

Fax

(509) 783-2008

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Derek J Peacock, MD

Title

Sole Proprietor

Phone

(509) 783-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Derek J Peacock MD PLLC Doing business as

Locations

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1316160237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST",
            "address_2": "SUITE C",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367806",
            "telephone_number": "509-783-2000",
            "fax_number": "509-783-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST",
            "address_2": "SUITE C",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367806",
            "telephone_number": "509-783-2000",
            "fax_number": "509-783-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA RHEUMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "509-783-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WA",
            "license": "MD00036578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104777",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derek J Peacock MD PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rheumatology Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Rheumatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.