Peak Nutrition and Weight Loss Clinic, P.a.

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

License

32989 Issued in NC

Legal business name

PEAK NUTRITION AND WEIGHT LOSS CLINIC, P.A.

Practice address

216 Village Walk Dr
Holly Springs, NC 27540-7681

Phone

(919) 586-0031

Fax

(919) 586-0035

NPI assigned

Jul 20, 2010

Organization subpart

Yes

Parent organization

PEAK NUTRITION AND WEIGHT LOSS CLINIC, P.A.As reported in NPPES

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

Authorized official

Name

Dr. Samuel D Blackwell, M.D.

Title

Owner/Medical Director

Phone

(919) 586-0031

Specialties & licenses 1

Addresses

Other names 1

• Peak Nutrition and Weight Loss Clinic Holly Springs Other name

Tax ID family

Peak Nurition and Weight Loss Clinic PA2 organizations share this tax ID, including this one

Part of

Peak Nurition and Weight Loss Clinic PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peak Nurition and Weight Loss Clinic PA

  • Metabolic Nutrition Registered Dietitian
  • Apex, NC
  • NPI 1942410725
  NPD tax ID

Locations

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1336452390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 VILLAGE WALK DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407681",
            "telephone_number": "919-586-0031",
            "fax_number": "919-586-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 VILLAGE WALK DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407681",
            "telephone_number": "919-586-0031",
            "fax_number": "919-586-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK NUTRITION AND WEIGHT LOSS CLINIC, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK NUTRITION AND WEIGHT LOSS CLINIC, P.A.",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-586-0031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "NC",
            "license": "32989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Nutrition and Weight Loss Clinic Holly Springs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nishang Patel, DMD
• Roshani Patel, OD
• Shimul Patel
• Nicole Paterno
• Emily Proctor Payne, D.D.S
• Emma Rachel Peck, PA-C
• Pediatric Therapeutics PLLC
• Perfectly Balanced Counseling PLLC
• Corissa Phannenstill
• Yuanlin Piao

• Obesity Medicine (Family Medicine) Physician in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Obesity Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.